It remains to be seen how many "healthy" people will sign up. And even those who are fortunate enough to hang onto their employer-provided health insurance plans may find out that their plans are little more than bronze as well. This is part of a recent trend with employer-based plans, where patients are already facing copays, coinsurance, and deductibles that are much higher than they were only a year or two ago.
If you can't collect the patient's share of payment effectively, you're in trouble.
That puts hospitals, the place where care is most expensive, in a difficult position. If they want to be fully paid for their work, and if they want to fulfill their contracts with health insurers, hospitals are required to collect these growing amounts of cash directly from patients.
They've been getting better at it, but a side effect of this change they haven't counted on until recently is a level of hatred, and at least as importantly, payment resistance, from patients.
I use the strong word "hatred" because when I was talking to a CFO about this problem in August at the HealthLeaders CFO Exchange in Colorado, he used that word when we talked about his organization's efforts to collect the patient's share of hospital payment.