Obamacare Not Yet One Year Old, Providers Preparing to Lobby for More Money

Now that Obamacare is rounding out its first year, and seems to be secure for the time being, providers who advocated for it are starting to change their lobbying tune. When Obamacare was less secure, the story was that it would improve the situation dramatically — for everyone.

Unfortunately, providers are already starting to complain that it’s not enough; they need more money.

Exhibit A: Connecticut hospitals. For the first time that I have seen, a hospital association has reported that Obamacare did not reduce uncompensated-care costs. The Connecticut Hospital Association claims that uncompensated care increased slightly from 2013:

“There clearly can be changes in [insurance] enrollment, but in the grand scheme of things, we’re not seeing that that change in enrollment is having a material impact on the burden that hospitals are having to manage dealing with those seeking out charity care services and those unable to pay for their share of coverage,” said Stephen A. Frayne, the hospital association’s senior vice president for health policy.

The article cites reasons for Connecticut’s uniqueness (primarily, little uncompensated care versus other states). Nevertheless, if Obamacare is made secure as a result of the 2014 and 2016 elections, I will not be surprised to see more hospital lobbyists take up this message.

Exhibit B: Community Health Centers.

Obamacare enrollees are straining the finances of community health centers around the country, some health center leaders say.

The issue is that many lower-income patients with insurance coverage through the federal and state exchanges bought bronze-tier plans with lower premiums but high deductibles, coinsurance and copayments and no federal cost-sharing subsidies. When these patients face high out-of-pocket costs for care that falls below the deductible, they can’t afford it.

So the centers are subsidizing that care by offering them means-tested sliding-scale fees. When the centers, which are not allowed to turn away patients for inability to pay, try to get the insurers to pay, the claims are usually denied, and the centers have to write it off as uncompensated care.

“People bought what they could afford and healthcare centers are in effect subsidizing these policies,” said José Camacho, executive director of the Texas Association of Community Health Centers. (Modern Healthcare)

Only a month ago, I discussed the (apparently short-lived trend) of free clinics (which are funded only by voluntary, local, or state funds) being crowded out by federally funded community health centers, which receive billions of dollars under Obamacare. I guess it’s not enough.

Within a year or two, I anticipate the prevailing opinion that Obamacare has stabilized providers’ funding will have disappeared down the memory-hole, replaced by the age-old mantra of “more money.”

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