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ACA Insurance Expansion and Uncompensated Hospital Care Costs

Hospital uncompensated care costs were $7.4 billion less in 2014 than they would have been if insurance coverage had remained at 2013 levels. That’s according to an updated analysis by HHS, based on estimated 2014 growth in insurance coverage due to the Affordable Care Act. It’s a 21% decrease in hospital uncompensated care between 2013 and 2014.

Medicaid expansion accounted for a significant portion of the uncompensated cost savings in states that expanded Medicaid versus those states that didn’t. An additional $1.4 billion in uncompensated costs might have been saved if the the non-expansion states had increased Medicaid coverage.

Here are the numbers from the report:

Hosp uncompensated care reduction & ACA

Furthermore, HHS analyzed hospital financial reports and found the volume of uninsured/self-pay admissions has fallen in major hospital systems, with a significant drop in states with Medicaid expansion.


Source: Insurance expansion, hospital uncompensated care, and the Affordable Care Act. US Dept. of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, March 23, 2015. http://aspe.hhs.gov/health/reports/2015/MedicaidExpansion/ib_UncompensatedCare.pdf

Related resources:

Economic impact of the Medicaid expansion. US Dept. of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, March 23, 2015. http://aspe.hhs.gov/health/reports/2015/MedicaidExpansion/ib_MedicaidExpansion.pdf

Uncompensated hospital care cost fact sheet. American Hospital Association, Jan. 2015. http://www.aha.org/content/15/uncompensatedcarefactsheet.pdf

See also earlier post: https://aharesourcecenter.wordpress.com/2014/09/26/impact-of-insurance-expansion-on-hospital-uncompensated-costs-in-2014/

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

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