The promise of the Affordable Care Act for hospitals was that bad debt -- a figure that reflects bills a hospital can't collect -- would shrink substantially under the law's coverage expansions. The reality, so far, is less uniformly dramatic, even though 9 million fewer Americans are uninsured. Even in states that agreed to expand Medicaid, the popularity of high-deductible plans in those insurance exchanges has added to hospitals' mounting concerns over how patients can pay those bills, if at all.
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