John asked a good question on Twitter yesterday about how does the medical care in Orlando or any other region get paid for when there is a mass casualty event:
Who pays for the medical care for uninsured and underinsured in mass shootings? Will a victim be forced to pay for their care?
— (((I Hate Nazis))) (@Johngcole) June 12, 2016
The traditional American response to this is either bake sales or GoFundMe.
That is still the case.
But that is not the complete case. Most states, including Florida, have presumptive eligibility for their Medicaid program. Presumptive eligibility allows hospitals to make a determination that an individual who is currently uninsured is likely to be eligible for Medicaid. They’ll start the paperwork and then get paid by Medicaid. The problem in Florida is that it is a non-expansion state so there is very limited eligibility for adults who were healthy until they were shot. At that point individuals who are uninsured are SOL for their initial emergency surgeries, treatment and recovery. Some people will get out with fairly clean wounds that require bones to be reset and wounds closed. They’ll get out with $10,000 or $20,000 bills that the GoFundMe page could handle. Other people with serious gun shot wounds could easily run up half million dollar claims by next weekend. The hospitals will try to go after any assets, but these people will declare bankruptcy.
Long term some of the people who are currently uninsured and not Medicaid eligible will be sick enough to qualify for Legacy Medicaid. That will cover rehabilitation and recovery expenses. For the individuals who are not sick enough to qualify for Medicaid based on their new disability status, they’ll be eligible to sign up for a new ACA policy on Exchange this November. It could be worth it to some of the individuals to move out of their current rating area to trigger special enrollment periods to buy Platinum plans that will carry them from July to December.
But yes, the people who were shot and lived but are uninsured are most likely financially screwed as they’ll be running up very large bills in a very short time frame and almost none of those services can be deferred until a better insurance plan can be put into place.