Hidden costs to reduce medical aid: Planet of money: NPR

With the passage of The large republican tax and spendingL, the federal government is preparing to limit Medicaid support and insurance markets set by the sponsorship law at reasonable prices. Congress Budget Office estimates that these cuts can cause 10 million Americans To inspect health insurance by 2034.

The legislators have justified these cuts as a necessary step for Treat the largest budget deficit Excess due to tax cuts and other spending increases in the large bill. However, this does not pick up how these reductions will send the costs that leaked around society, paid by hospitals, clinics and individuals, then in the end, to the federal government.

Where do people go if they are not insured?

Health care is different from other commodities, such as movie tickets, cocktails or cars. If people cannot pay for health care, they suddenly stop the need for it. So, where do people get their health care if they do not have health insurance?

One option is Federal qualified health centers (FQCS)-Community clinics that provide comprehensive primary care for low-income persons, dental services, mental health, drug use, and specialized care. FQHCS charge a Subsidized Based on the ability to pay, with 90 % of their patients in or less 200 % of the federal poverty line. They are a vital source of care of the unlikely or the insured, with more 15,000 sites It serves more than 31 million patients in 2023.

Certainly reducing the number of people on Medicaid will reduce taxpayers dollars to the Medicaid program. But FQHCs depends on Medicaid patients The main source of revenueAnd he used grant financing from the federal government to cover the costs of providing care for the insured. The discounts in the coverage of medicaid, without an increase in federal scholarships to cover the costs of the insured, can threaten the stability and scope of the FQHCs. Even with grants grants $ 5.6 billion in 2023FQHCs is working on Thin marginsAnd the enrollment of Modiid after the Covid-19 pandemic has exacerbated its financial powers. Therefore, less than increased grant financing, clinics may have to Lower spending for each patientHe was able I wish you more difficult time to recruit and keep medical service providersOr Reducing the number of services I was offered to patients. This may lead to more insured patients to resort to hospital emergency rooms to bridge the gap.

Hospitals are like levels of insurance companies in the last resort

Because of a variety of factors, hospitals should treat patients regardless of their ability to pay. For example, Federal Law Hospitals require care for all patients who appear in their emergency departments. In addition, federal law imposes that non -profit hospitals must provide some Society benefits through charitable careOr “Free or reduced health services” To maintain a tax exemption. Non -profit hospitals are an important source of care – nearly half of all hospitals in the United States Non -profitable. Medical ethics also force doctors to be “The righteous Samaritans” And the treatment of patients regardless of their ability to pay.

Through the state of tax exemption for non -profit hospitals, taxpayers effectively support some of these charitable care. But the intericaid cutting will also harm hospitals. Half of the rural hospitals already Work in a deficitAnd threaten medical cuts Pay 300 additional hospitals “Towards a financial cliff”. While the concern about the closure of rural hospitals led to an additional $ 50 billion to “Rural health conversion program“An analysis by KFF is estimated that this is only Modify a third of the lost revenues From medical aid discounts.

paper By the economists Craig Gardethoute, Tal Gross, and Matthew Notodedo He argues that hospitals are “insurance companies in the last resort.” When policy makers reduce the joining of the Moody, hospitals eventually bear the cost. according to Mackak (Payment and Access Committee for Medicaid and Chip) Hospitals have provided unknown care of $ 22.5 billion to unconfirmed individuals in 2021, bringing the total approximately $ 40 billion spending on charitable care and bad debts (or, about 5 to 6 % of hospital expenses). Using hospitals financial statements, authors estimate that each visit is not insured, on average hospitals hold $ 11,000 of unequal care costs.

Non -profit hospitals, whether religious or secular alike, reported the costs of higher sponsorships that are not disabled. When the unbelievable population increases, hospitals aimed at profit are of small and unimportant effects on the costs of unprocessed care. Every additional non -believers in the country, on average, leads to an additional $ 800 paid by hospitals in unprocessed care costs.

Medical religion

Until now, we have found that the increase in the unbelievable population puts financial burdens on two important parts of the social safety network: community health clinics and non -profit hospitals. But what about the patients themselves?

Even among those who have health insurance, expensive medical bills can perform with high discounts and share costs to medical debt and in some cases, bankruptcy. and KFF analysis I found that 20 million people, or about 8 % of adults, have a form of medical debt, with about 6 % of adults due to more than $ 1,000. In total, people in the United States carry $ 220 billion in medical debts. The occurrence of medical debts is higher among the insured (11 %), low -income persons (11 %), and those with disabilities (13 %).

Failure to secure and establish an internal patient hospital can spell financial disasters. this TicketHe finds “the economic consequences for accepting the hospital” that obtaining the hospital’s acceptance, while the insured increases the probability of bankruptcy by approximately 40 %. They estimate that the admission operations in hospitals are able to be responsible for about 6 % Of bankruptcy For the non -insured, even 4 % of bankruptcy cases of the insured.

However, the research constantly shows that obtaining coverage can save the insured from medical ruin. Using Medicaid expansions from the mid -nineties and early first decade of the twentieth century, and the other Ticket It finds that an increase of 10 ° C in Medicaid eligibility reduces consumer bankruptcy by 8 %. Famous Health insurance experience in OregonWhich randomly gave Medicaid coverage, finds similar results. The presence of health insurance reduces the possibility of sending an unpaid medical bill to group agencies by 25 % and reduces the possibility of medical expenses outside the pocket by 35 %.

Bad health makes us all poor

Being an insured, from the concept, is bad for your health: unlikely unbelievable receipt Less preventive careYou have more difficulty getting Prescribed Dental care, less likely to get Specialized care They need. It is also a bad economic matter for the non -insured as we have shown above. But the unhealthy population is bad for the economy itself as well: Long -term evidence He explains that the presence of insurance coverage as a child improves future productivity as an adult. By the age of twenty -eight years of age, those with Medicaid coverage as a child had to join the highest college, higher wages, and used fewer government benefits. This paper is estimates The government was able to recover 58 cents on every dollar spent on medical childhood coverage. The presence of a sick worker is only Bad for economic growth: Workers work in poor health for less hours, which reduces our general Work productivity.

Therefore, the federal government may save money by tightening Medicaid, but this will put pressure on other parts of the economy. Both community health clinics, hospitals, patients and taxpayers will put the bill in some respects, and of course the unbelievable.