The Impact on Health Care Providers of Partial ACA Repeal through Reconciliation

A man waits in a hospital waiting room.

If the Affordable Care Act (ACA) is repealed, spending on uncompensated care would increase by $1.1 trillion over 10 years.


The Issue

If Congress repeals the ACA, the amount of uncompensated care delivered to the uninsured at a free or reduced rate would increase from $656 billion to $1.7 trillion over a 10-year period.

Key Findings

  • In 2019, Medicaid, private insurance, and household spending on health care would fall by $145.8 billion, and an additional 30 million uninsured people would seek $88.0 billion in uncompensated care.

  • Federal funding for uncompensated care would increase by no more than $3.2 billion in 2019 unless legislative action was taken.

  • Financial burdens on state and local governments, health care providers and the uninsured themselves would likely rise dramatically.


The partial repeal of the ACA through a reconciliation bill being considered by Congress would increase the amount of uncompensated care sought by the newly uninsured. This demand would be more than state and local governments and health care providers could handle, leading to substantially more unmet medical need.


About the Urban Institute

The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. Visit the Urban Institute’s Health Policy Center for more information specific to its staff and its recent research.