According to a new study by TransUnion, two-thirds of hospital patients are not paying their hospital bills in full. TransUnion also suggests that, by 2020, this number may rise to 95 percent. This seems to be mostly due to the increase in deductibles that came with the Affordable Care Act. However, it must be noted that while the act did increase deductibles, it has also given more people access to health insurance.

This could have long-lasting consequences for many hospitals across the country. According to The North Carolina Rural Health Research Programs, 79 rural hospitals have closed between 2010 and the present. According to reports, hospitals in states who chose not to expand Medicare with the Affordable Care Act are under much higher pressure to either expand profits or close compared to hospitals in states that did expand Medicare.

John Yount, the vice president of product within the TransUnion’s healthcare division warn that this number will only increase if more and more patients choose or are not able to pay their bills. Yount believes the healthcare industry should both move to an outcome-based payment structure and help keep healthcare costs down in order to help keep hospital closures from happening, as studies show that the main reason that patients do not fully pay their hospital bills is due to the high healthcare costs. In fact, it has been reported that 99% of patients with hospital bills that total more than $3,000 do not completely pay their bills.

With this said, even though healthcare costs are high, hospitals are not making an overabundance of profit. Currently, hospital profit margins range from two to four percent, and that margin tightens when patients refuse or are not able to pay their bills. Lastly, while the repeal of the Affordable Care Act currently seems dead in the water, future healthcare laws and provisions may increase or decrease the severity of the aforementioned hospital related financial crises.