Uncompensated Care for the Uninsured in 2013: A De

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Uncompensated Care for the Uninsured in 2013: A Detailed Examination

Context is everything, unless you have an ideological agenda. Then there is no such thing as context.

Teresa A. Coughlin, John Holahan, Kyle Caswell, and Megan McGrath
Published: May 30, 2014

https://www.kff.org/uninsured/report/uncompen...amination/

Despite not having health insurance, millions of uninsured Americans use health care services every year. Since health care is costly and the vast majority of uninsured have limited financial means, many uninsured often cannot pay their medical bills.

Recognizing the need for and importance of health care providers that care for those without insurance, the federal government, states and localities have long provided support—financial and otherwise—to help defray providers’ the costs of caring for uninsured individuals.

With the enactment of the Affordable Care Act (ACA), millions of previously uninsured individuals will gain insurance coverage through either Medicaid or private plans purchased through the health care marketplaces.

As people gain coverage, providers’ costs associated with caring for uninsured individuals that previously went uncompensated will decline, as more people have a direct source of payment (insurance) for their care.

In this paper, we take a close look at uncompensated care in 2013, just before implementation of health reform’s major coverage provisions. These estimates provide an important baseline against which to measure major changes that are occurring under the ACA. Key findings from the analysis include:

• On average, a person who is uninsured for the entire year will incur considerably lower medical expenses than someone who is insured for the full year. In 2013, the average uninsured person had half the amount of medical expenditures as the average insured person ($2,443 versus $4,876).


• In 2013, the cost of “uncompensated care” provided to uninsured individuals was $84.9 billion. Uncompensated care includes health care services without a direct source of payment. In addition, people who are uninsured paid an additional $25.8 billion out-of-pocket for their care.

• The majority of uncompensated care (60%) is provided in hospitals. Community based providers (including clinics and health centers) and office-based physicians provide the rest, providing 26% and 14% of uncompensated care, respectively.

• In 2013, $53.3 billion was paid to help providers offset uncompensated care costs. Most of these funds ($32.8 billion) came from the federal government through a variety of programs including Medicaid and Medicare, the Veterans Health Administration, and other programs. States and localities provided $19.8 billion, and the private sector provided $0.7 billion.

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