The Effect of the ACA on Charity Care Expenditures

Illinois hospitals have long accommodated indigent patients. Current law obligates that the majority of hospitals within Illinois are required to provide free and reduced cost emergency care for the un and underinsured. Anyone, regardless of their immigration status, can qualify for this care known as "Charity Care". Throughout this study, we will be analyzing trends from 2008-2010 and 2014-2016 to assess Inpatient, Outpatient, and Total Net charity care expenditures prior to and after the implementation of the Affordable Care Act. The counties we will be assessing include Champaign County, Coles County, Edgar County, Ford County, Macon County, McLean County, Piatt County, and Vermilion County. The selected counties being observed fall under the HUPDA amendments that apply to Rural and/or Critical Access Hospitals. After the enactment of the ACA, these hospitals are obligated to provide a charitable discount of 100% to any of the uninsured, inpatient or outpatient, who applies and has a family income 125% or more below the poverty line. We hypothesize that charity care reimbursements rates will decline due to the expansion of Medicaid, unemployment rates declining, and the increase in preventative care.Ope