CRH sees 23% increase in uninsured emergency room visits

Emergency room visits by uninsured patients at Columbus Regional Hospital rose 23% during the first seven months of the year, a jump hospital officials largely attribute to the expiration of enhanced Affordable Care Act subsidies, Medicaid coverage losses and changes in insurance networks.

From Jan. 1 to July 29, CRH recorded 1,826 emergency department visits by uninsured patients, up from 1,481 during the same period last year, according to data provided by the county hospital system. Total emergency room visits were largely flat over the same period.

While CRH typically sees modest year-to-year fluctuations in uninsured emergency room visits, the increase this year is "an abnormal trend," said CRH spokeswoman Kelsey DeClue.

"It's definitely outside the norm," DeClue said. "…We have seen slight fluctuations from time to time, but nothing as evident as this increase."

The increase comes as states across the country have seen steep drops in the number of people covered by the Affordable Care Act over the past year, The Associated Press recently reported, citing data released by the Trump administration in late June.

The data provided the first snapshot of sharp enrollment declines following the January expiration of enhanced subsidies, which led to around 2.6 million fewer Americans having Obamacare plans in February compared to the same point a year ago, according to wire reports.

At the same time, Indiana's Medicaid enrollment fell by more than 343,000 people, or 18.5%, between June 2025 and June 2026, according to the Indiana Family and Social Services Administration.

The Indiana Capital Chronicle reported this week that while some Medicaid enrollees lost coverage because they no longer qualified, state data show many more were removed for procedural reasons, such as failing to return renewal forms or provide requested documentation on time.

Overall, just over 3,700 Bartholomew County residents have dropped off the rolls of Medicaid and Affordable Care Act plans over roughly the past year, according to federal and state records.

A total of 2,888 fewer Bartholomew County residents were enrolled in Medicaid this past June compared to June 2025 — a 15% decline — according to the Indiana Family and Social Services Administration.

Additionally, 819 fewer Bartholomew County residents enrolled in American Care Act plans this year compared to last year — a 21% decline — according to the Centers for Medicare and Medicaid Services.

Insurance network changes may also be playing a role in the local increase in uninsured visits, officials said.

"There are changes to the Affordable Care Act, and then other individual insurer changes with in-network and out-network changes with certain insurance companies and Medicaid cuts at the government level," DeClue said. "…We would say that we are now clearly seeing the effects of those (changes)."

The increase at CRH also comes as executives at some of the nation's largest hospital operators recently told investors in earnings calls that patients who lost American Care Act marketplace coverage did not find coverage elsewhere, The New York Times reported.

HCA Healthcare's chief executive, Sam Hazen, said former exchange patients had largely shifted to uninsured status. Community Health Systems reported that visits from patients not using insurance rose 20% during the first half of the year, while SSM Health, a nonprofit Catholic system, said its uninsured patient count increased 21%.

Roughly 30 million adults and children in the United States are uninsured, according to The New York Times.

CRH officials, for their part, expressed concern that the loss of insurance coverage may cause local residents to delay routine medical care until issues become an emergency. The hospital is not turning away uninsured patients, officials said.

"We also are pretty certain that (the increase) could continue to climb," DeClue said. "…It certainly isn't going to slow down, because we're only halfway through the year. We're only halfway through seeing the impact, and unfortunately, we know there are probably a lot of people out there who are still delaying care."

"It really is the patients who suffer," DeClue added. "…We're going to see the trickle-down effect of people not being able to have access to a human right, which is medical care."

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