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The Shift in ACA Enrollment is Driving More High Deductible Health Plans
Description
In this episode, Tom Furr, CEO and Founder of PatientPay, discusses how the Shift in ACA enrollment is driving more high deductible health plans.
Highlights of this episode include:
- How the reduction in ACA enrollment numbers are affecting out-of-pocket payments
- How should providers prepare for this change in coverage
- Long-term projections
Kelly Wisness: Hi, this is Kelly Wisness. Welcome back to the award-winning Hospital Finance Podcast. We’re pleased to welcome Tom Furr. Tom is the CEO and founder of PatientPay, the leading patient payments partner for acute, ambulatory, and specialty care organizations. Prior to founding Patient Pay, Tom was the CSO and COO and board member at MobileSmith Health. He was also a co-founder and president of Kinetics Inc., an early online commerce provider for small businesses with partners such as Wells Fargo, First Union, and Netscape. In this episode, we’re discussing the shift in ACA enrollment and how it’s driving more high-deductible health plans. Welcome, and thank you for joining us, Tom.
Tom Furr: Hey, thanks for having me, Kelly.
Kelly: All right, well, let’s go ahead and jump in today. So how is the reduction in ACA enrollment numbers affecting out-of-pocket payments for providers?
Tom: Yeah, obviously, the Affordable Care Act was in the media a lot back in December. And so, it kind of got me thinking of, well, if these people leave the ACA, does that mean they’ll be uninsured, or do they move back to the employer insurance? And so, I started looking at the data out there and it’s quite interesting. It’s obviously, as of, I think, a week or so ago– and these are all numbers from Google Gemini. So, if they’ve changed, blame it on Google. But there was about 1.4 million people that had– or 1.2, 1.4 million that had left the ACA. And the ACA has kind of grouped within the private insurance market. And so, the private insurance market had been growing from ‘24 to ‘25. It was up about 1.4 million folks that were subscribing to insurance and are paying for insurance. And so, the question is, if they’re uninsured, there’s a different way to approach it if you’re a hospital or you’re an ambulatory group or what have you. If it’s insurance, what is that insurance going to look like? And so, what the numbers, the stats are looking at right now is,