My son was premature and racked up 14 days in the NICU. The hospital (which is 'legally a charity' billed $250,000.00. We were low-income with no employer-provided medical insurance, so the state Medicare provider got to pay a reduced rate of that.
As far as I know, Hospitals are not allowed to refuse you care; no matter what your finances are, they have to help you. Many people would go to ER for non-ER reasons because it was/is the only way for them to get treatment. (Because other medical centers can refuse you.)
The hospitals will try to get the money from you however they can and they do offer payment plans based on income. Ultimately, though, due many? The debt gets discharged to a debt collection agency that harasses you incessantly for 7 years until it gets discharged from your record.
It destroys your credit (an arbitrary number that every citizen has that supposedly shows how trustworthy they are and how much they are likely to pay you if you loan them money) until it drops off after the statute of limitations (7-10 years, depending on the state).
Unless you enter through the ER, a healthcare system can deny you.
Also, the ACA requires hospitals have a charity care program and notify people about it (often buried pages deep in your discharge papers). If you qualify, they’ll write off your debt and count it towards their “charity care,” which helps them justify their non-profit status, when applicable. The ACA has no rules about what charity care looks like and the hospital can set whatever criteria they want (some may have charity for those under 100% FPL, others higher).
Source: I’m in a masters program studying this
Question to Americans, is it a secret way to make poor people not have children?
If it is, it's a bad one lol. Poor people tend to have more kids, just in general, and that doesn't change in the states.
No I think it's the opposite. They expect people to get pregnant and have kids (though with abortion and birth control that is happening less- hence targeting those recently). This is designed to make sure they stay poor so that the wage slave class stays well populated.
Giving birth is an inexorable* consequence of being pregnant.
... Which itself is an inexorable* consequence of living in a state that decries and represses reproductive freedom.
Which is what the rest of (in the US) will all have to face down in the next 10 years.
Fun, right?
*s inexorable, as in what the GOP demands any more go forth and multiply, OR ELSE!
Healthcare in the US generally screws the middle, not the poor, even then it's the lower middle. The poor qualify for Medicaid which generally pays for anything major and basic healthcare, though options may be limited. The old get Medicare which covers pretty much everything outside a nursing home for fairly little out of pocket. The middle and upper class generally has decent insurance that isn't crazy expensive to have and doesn't have a ton of out of pocket costs provided by an employer.
It's the people with high deductible plans that can't or won't contribute to an hsa, and those that don't have employer provided healthcare that really get screwed.
Ours was completely covered by state provided health insurance.
One thing others haven’t mentioned: most states accepted the ACA Medicaid expansion, which means most poor people qualify for Medicaid (at least in 80%ish of states). Medicaid is pretty cheap out of pocket. It can get complicated around who accepts the insurance, but almost any hospital where you go to give birth will.
Part of the issue with healthcare costs in the US is that many people never pay. That means those with insurance have to cover them via higher prices.
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