Health Care Act

Rush for care could result if Supreme Court ends NC subsidies

If hundreds of thousands in North Carolina lose health insurance subsidies, there could be a rush on care while people can still afford their premiums.
If hundreds of thousands in North Carolina lose health insurance subsidies, there could be a rush on care while people can still afford their premiums. Image: larrycuban.wordpress.com

If the Supreme Court strikes down Affordable Care Act subsidies later this month, we can expect financial and political turmoil to ripple through the next several months. But one reaction could come quickly: A rush on doctor’s offices.

Almost 459,000 North Carolinians get federal aid to buy health insurance. If the court rules in favor of the plaintiffs in King v. Burwell and that money goes away, their monthly premiums will increase by an average of more than 300 percent, according to recent federal data.

People who can’t keep paying premiums may hustle to book appointments, tests and elective surgery before their insurance is canceled.

“That wouldn’t be inconsistent with what we see at the end of the calendar year,” when offices are packed with people who have met their deductibles and want to get care before the start of the new year, said Bob Seehausen, a senior vice president with Novant Health. “That would be a logical behavior.”

The inconvenience of a summer/fall crush would be just the start of challenges for patients, doctors and hospitals. If relatively healthy people drop their ACA policies, the cost of covering the sickest customers will eventually be spread to everyone who has insurance. (Even if the the Supreme Court rules that the subsidies can continue, North Carolina insurers are seeking hefty rate hikes for 2016, saying the ACA has attracted older, sicker and more costly customers.)

And as people lose insurance, medical providers would see an increase in charity care and unpaid bills.

Seerhausen says Novant will keep providing care, regardless of whether patients pay. But he said a surge in charity care means “some of the cost gets passed on to the people who still have insurance. We’re all impacted.”

Helms: 704-358-5033;

Twitter: @anndosshelms. This blog post is done in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

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