In the wake of the U.S. Supreme Court’s decision1 upholding the Patient Protection and Affordable Care Act and the accompanying Health Care and Education Reconciliation Act (collectively, ACA), healthcare providers are attempting to gauge the effect of the new law on operations. Of particular interest is the impact upon financially stressed providers. The ACA will result in 32 million additional insureds through (i) broader Medicaid eligibility, and (ii) mandating that virtually every citizen obtain health insurance and establishing healthcare exchanges. The ACA also requires Medicare reimbursement reductions, reductions in aid to hospitals that treat uninsured patients, and lower reimbursements for hospitals failing to comply with the ACA’s quality mandates and reporting requirements.
Given that community-based hospitalsoften those operating on a standalone basis and not part of a larger systemface existing operational deficiencies, the ACA could impose greater costs upon hospitals that need to meet certain levels of patient care to avoid decreases in reimbursement revenues.
