As the crisis surrounding medical costs continues to plague the American health system, hospitals are feeling the strain along with patients. Hospitals across the United States are facing growing financial pressure as more patients arrive without health insurance after losing Affordable Care Act (ACA) coverage, according to a recent New York Times article. The rise of uninsured patients has led to more Americans being unable to cover medical costs, causing hospitals to absorb those expenses.
The number of uninsured patients has risen by roughly 20% at some hospital systems. At nonprofit SSM Health, for example, the number of uninsured patients increased nearly 21% from last year, while bad debt rose almost 37%. As reported by The New York Times: “What that tells me is that there are patients who are completely unable to pay. We’re really crushing people who are desperately trying to pay their bills,” said Laura Kaiser, the CEO of SSM Health, a nonprofit Catholic hospital group, who is expected to become chair of the American Hospital Association, an industry trade group, in 2028.
Factors Causing People To Walk Away From ACA
One major factor is the reduction in federal subsidies that helped consumers pay ACA premiums. Although most people enrolled in ACA plans still receive financial assistance, the subsidies are less generous in 2026. People earning more than four times the federal poverty level no longer qualify for assistance. Overall, ACA enrollment has fallen by about 3 million people, or 13%, since the beginning of the year.
The impact is especially visible among major hospital chains. HCA Healthcare, the nation’s largest for-profit hospital system, said many former ACA enrollees appear to have shifted directly into uninsured status. The company expects the resulting decline in revenue to reduce operating profits by roughly $1 billion this year. Community Health Systems reported a 20% increase in visits from patients paying without insurance, while Tenet Healthcare described a similar shift.
The Effect on Hospitals
Hospitals are also seeing patients delay or avoid care. Some are postponing joint replacements, heart testing and other procedures because household budgets have become increasingly strained. Higher insurance premiums, deductibles and everyday expenses are making medical care harder to afford.
Ultimately, the growing number of uninsured Americans could affect everyone. Federal law requires hospitals to provide emergency treatment regardless of a patient’s ability to pay. As hospitals absorb more uncompensated care, they may raise prices for insured patients to make up for lost revenue.
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This article includes data from a piece originally appearing in The New York Times.
