Xiaoyi Huang, vice president for policy at America's Essential Hospitals, says safety net hospitals don't know yet what the exchanged-based plans are going pay.
"All of our member hospitals are essential community providers and there is some language in the ACA about rates that all of the health plans have to pay essential community providers but it is very broad language," she said.
"Beyond that, it is up to the individual providers to negotiate with the plans depending upon who has the better budgeting position to figure out how much of their costs are covered through the rates. But honestly we don't know what that rate is."
"We care about whether our hospitals are included in the networks of these plans just because if you are not in the networks, you are automatically off to a disadvantage. But even for those that are included, we at this point don't have a systematic sense of what types of rates are being offered. We hope it is not as low as Medicaid because then you are just trading one form of uncompensated care for another."
Ellen Pryga, director for policy at the American Hospital Association, says hospitals are trying to predict the effects of a broad set of factors.