Hospital Groups Want Say in ACA Lawsuit

Cheryl Clark, for HealthLeaders Media , November 17, 2010

According to the hospital groups' brief, hospitals in 2008 provided uncompensated care valued at $36.4 billion, "a disturbing upward trend in uncompensated care, and Congress' attempt to reverse it through the Patient Protection and Affordable Care Act is precisely what is at issue in this litigation."

Not only do these hospitals have to provide emergency care to anyone, regardless of ability to pay, "even when an uninsured patient arrives planning to pay his or her own way, that patient may struggle to pay for an extended hospital stay." 

They absorb expenses to help patients determine if they meet eligibility requirements for financial assistance, financial counseling, sliding-scale payment policies, interest-free loans and other incentives that help patients receive grants and qualify for Medicaid.

"The ACA represents a comprehensive effort to extend coverage to millions more Americans to make care available to patients in doctors' offices, clinics and other settings, keeping them out of emergency departments and hospitals unless they need to receive care there," the AHA said in a statement.

"For these reasons, the hospital associations and their members arguably will be more directly affected by the decision in this case than any other institutional group in the nation."

In its argument to be included, the hospital groups said they intend to explain "how the decision made by some uninsured Americans to delay or forgo routine preventive care actually increases the amount, and the cost, of the care they need when an avoidable illness eventually brings them to the hospital."  It would also "explain how the costs of caring for the uninsured are absorbed not just by hospitals but also by private insurers and taxpayers."

McAndrews notes that how employers respond to the individual mandate provisions—whether they will continue to purchase group plans or instead pay a penalty—will determine how effective the individual mandate will be in getting more people to buy coverage.

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