ACA rules leaves hospitals liable when marketplace enrollees stop paying premiums

Hospitals are protesting a federal rule in the Affordable Care Act that they say will leave them liable for unpaid bills when patients who get their coverage through the online marketplace fall behind on paying premiums (Source: “Hospitals liable when Obamacare enrollees don’t pay,” Columbus Dispatch, Aug. 23, 2013).

The ACA calls for insurers to allow a 90-day grace period for coverage after a consumer stops making payment. The rule allows health plans to suspend claims for services that delinquent enrollees receive during the second and third months of the grace period, leaving hospitals responsible for the costs.

The American Hospital Association said it hasn’t estimated how much money might be at stake. “Whatever the cost of the grace period, it went from 100 percent liability for the health plans to only a third of the liability,” the association said in a statement. “For providers, it went from zero liability (other than deductibles and cost-sharing) to two-thirds of the liability for all the services.”