Not-for-Profit Hospitals Debate How To Apply Aid for Uninsured
Hospitals appear divided about whether to grant financial aid to uninsured patients who are eligible for subsidies to help purchase coverage through the Affordable Care Act's exchanges, Modern Healthcare reports.
The ACA includes new collection and financial aid rules that not-for-profit hospitals must follow to keep their tax-exempt status. However, the ACA does not state explicitly which patients should be eligible for financial aid.
About 60% of U.S. hospitals are not-for-profit, and charity care spending varies widely, according to Modern Healthcare.
Aid Limitations Could Save Resources, Encourage Enrollment
According to Modern Healthcare, many hospitals are debating whether it is appropriate to allocate limited financial resources to uninsured patients who are eligible for the subsidies. Some believe restrictions on financial help could encourage such patients to purchase coverage.
Keith Hearle, president of Verite Healthcare Consulting, said a small number of hospitals have decided to deny charity care those eligible for subsidies. However, he added that such policies likely will become the norm.
Health systems that have adopted rules to limit charity care include:
- Trinity Health, an 86-hospital Catholic system;
- Broward Health, a tax-supported safety-net system; and
- The Southern New Hampshire Health System.
Uninsured Still Face Confusion, Financial Barriers
Meanwhile, other providers have opted not to deny financial aid to individuals eligible for subsidies.
For example, Denver Health, the city's safety-net hospital, does not intend to change its financial aid policy. Bill Burman, director of Denver's Public Health Department, said, "I don't feel it's appropriate to say you must do this brand-new thing or you can't get care," adding that the introduction of subsidies to help purchase coverage "was a big change and not a simple one."
In addition, advocates have noted that despite tax credits, coverage costs remain high for many because:
- High deductibles;
- Co-insurance; and
- Copayments (Evans, Modern Healthcare, 12/6).