Fitch Ratings said ACA repeal would be especially harmful to non-profit providers.
“Any reduction in the ACA, either through repeal, piecemeal legislative efforts or legal challenges to its constitutionality, is detrimental for the U.S. not-for-profit healthcare sector, particularly in those states that have or are expanding Medicaid,” Fitch Ratings said in a statement.
S&P Global Ratings agreed that while a repeal of the legislation would hurt for-profit hospitals, it would be much worse for their non-profit counterparts.
“Most notably tax-exempt hospitals and healthcare systems — which provide the bulk of U.S. healthcare — will see a broad diminution in credit quality over time in our view as the growth in both bad-debt expenses and charity care costs would directly lower operating margins,” S&P said. “For-profit hospital systems will also experience increased uninsured business and therefore higher uncompensated care and margin pressure, but most likely not as bad as tax-exempt hospitals because they typically operate in markets that tend to have a more commercially focused payer mix.”
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