Court Holds Key to $740 Billion in Health Spending: BGOV Study

By Matthew Barry

The U.S. Supreme Court may rule in the next few weeks on the constitutionality of the Patient Protection and Affordable Care Act. At stake for hospitals, drugmakers, nursing homes and home health providers are billions in revenue that will be lost if the entire act is struck down or gained if the court upholds any or all provisions of the act.

This Bloomberg Government Study, the second of two parts, examines the financial impact on these providers if the court rules for or against the two key provisions of the law: a requirement that every citizen purchase health insurance, the so-called individual mandate; and a major expansion of Medicaid, the federal-state health insurance program for the poor and disabled.

Part 1 of the study found that the health insurance industry alone has more than $1 trillion in new revenue at stake from 2013 to 2020, or about 9 percent of its projected revenue for that period, if the court strikes down all or parts of the law. Much of that money would flow through to health-care providers, of course.

Part 2 of the study looks at the other major health-care industry providers and finds that hospitals, drugmakers, home health providers and nursing homes combined would get three-fourths of that amount under the terms of the law.

  • Hospitals: $430 billion, or 4.7 percent of projected national health expenditures for the hospital industry sector.
  • Drugmakers: $124 billion, or 3.8 percent of projected spending for the drug sector.
  • Home health providers: $94 billion, or 11 percent of projected spending for the sector.
  • Nursing homes: $87 billion, or 5.9 percent of projected spending for the sector.

Projected federal spending on hospitals, drugmakers, home health providers and nursing homes from 2013 to 2020 equals almost one-half a percentage point of the projected size of the U.S. economy, as measured by the gross domestic product. Total national expenditures on health are projected to equal almost 19 percent of GDP over the same period of time.

Matt Barry is a health analyst for Bloomberg Government focusing on Medicare, Medicaid, public health and prevention issues. Barry has more than 20 years of health policy experience in the executive and legislative branches of the federal government, non-profits, private consulting and public affairs firms.

He has worked on payment and access issues under Medicare and Medicaid, tobacco control policy, rural health care, and childhood immunization policy.

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