Sign up for our daily briefing

Make your busy days simpler with Axios AM/PM. Catch up on what's new and why it matters in just 5 minutes.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Catch up on the day's biggest business stories

Subscribe to Axios Closer for insights into the day’s business news and trends and why they matter

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sign up for Axios Pro Rata

Dive into the world of dealmakers across VC, PE and M&A with Axios Pro Rata. Delivered daily to your inbox by Dan Primack and Kia Kokalitcheva.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sports news worthy of your time

Binge on the stats and stories that drive the sports world with Axios Sports. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Tech news worthy of your time

Get our smart take on technology from the Valley and D.C. with Axios Login. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Get the inside stories

Get an insider's guide to the new White House with Axios Sneak Peek. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Denver news?

Get a daily digest of the most important stories affecting your hometown with Axios Denver

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Des Moines news?

Get a daily digest of the most important stories affecting your hometown with Axios Des Moines

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Twin Cities news?

Get a daily digest of the most important stories affecting your hometown with Axios Twin Cities

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Tampa Bay news?

Get a daily digest of the most important stories affecting your hometown with Axios Tampa Bay

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Charlotte news?

Get a daily digest of the most important stories affecting your hometown with Axios Charlotte

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Nashville news?

Get a daily digest of the most important stories affecting your hometown with the Axios Nashville newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Columbus news?

Get a daily digest of the most important stories affecting your hometown with the Axios Columbus newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Dallas news?

Get a daily digest of the most important stories affecting your hometown with the Axios Dallas newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Austin news?

Get a daily digest of the most important stories affecting your hometown with the Axios Austin newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Atlanta news?

Get a daily digest of the most important stories affecting your hometown with the Axios Atlanta newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Philadelphia news?

Get a daily digest of the most important stories affecting your hometown with the Axios Philadelphia newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Chicago news?

Get a daily digest of the most important stories affecting your hometown with the Axios Chicago newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sign up for Axios NW Arkansas

Stay up-to-date on the most important and interesting stories affecting NW Arkansas, authored by local reporters

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top DC news?

Get a daily digest of the most important stories affecting your hometown with the Axios DC newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Pixabay / Creative Commons

Hospital executives know that if Obamacare is repealed and not replaced, the ranks of the uninsured will swell, and they will still be required to treat those patients.

That's why they're hit especially hard these days by the uncertainty over what will happen and when, as Republicans try to figure out how they want to get rid of the law. The biggest concerns for hospital executives: losing Medicaid payments, and having more privately insured patients who can't pay their bills because of high out-of-pocket costs. Hospitals were just getting relief from uncompensated care, and don't want those costs to rise again.

The primary concern: It's not the potential loss of patients with private Obamacare insurance that worries hospitals the most. It's the loss of patients with Medicaid coverage.

Even though state Medicaid programs pay hospitals less than Medicare or private insurers, it's still been better than nothing. That's why state hospital associations have aggressively lobbied for Medicaid expansion in Republican states that haven't embraced it.

Dennis Dahlen, chief financial officer of Banner Health in Phoenix, recently said there could be "dire consequences" if Medicaid expansion is rolled back and if Republicans move toward Medicaid block grants. That would threaten revenue immediately and lead to more uninsured patients walking into the emergency room.

"Our biggest exposure and biggest concern is Medicaid funding," Dahlen said. About 13% of Banner's patient revenue comes from Medicaid.

Why it matters: Obamacare has helped mitigate the tide of uncompensated care for hospitals in expansion states, the Kaiser Family Foundation notes. Hospitals are ready to fight to prevent that from reversing.

Dan Morissette, chief financial officer of Dignity Health in San Francisco, told bondholders the system will work with Congress and state governments on "preserving access to care for vulnerable populations." That's a hint that Dignity will work behind the scenes to pressure lawmakers from unraveling Medicaid expansion.

Another long-term financial concern: It involves hospitals' most profitable form of payment: private health insurance.

Employers and commercial insurers have been shifting more costs onto people through higher deductibles, copays and coinsurance. That won't slow down regardless of what happens to Obamacare, and likely will accelerate, under Republicans, who have championed tax-free health savings accounts and the need for consumers to have more "skin in the game."

This presents multiple problems for health systems. Studies show people don't seek medical care as often if they know they have to pay more out of pocket. And when they do go, many are slammed with medical bills they can't pay or don't know about, and hospitals increasingly have to play the role of collections hunter.

"You don't get this massive uptick in utilization, and on top of that, you have problems with bad debt," said Spencer Perlman, a health care analyst at Height Securities.

The push for price transparency. A post-Obamacare environment of "consumer-driven" health care — meaning consumers are exposed to more costs — also could make it more difficult for hospitals to hide behind opaque pricing practices.

Although several researchers have found price transparency would barely move the needle on health care spending, the price transparency movement could gather more steam if more people are on the hook for payments.

Go deeper

Americans are super-sizing their holiday travel

Illustration: Sarah Grillo/Axios

Americans are rushing back into holiday travel, and many are taking even longer trips now than they did before the pandemic began.

The big picture: After skipping Thanksgiving and Christmas gatherings last year, many people are eager to maximize this year's celebrations with friends and family. And flexible remote working arrangements make that easier than ever.

Updated 16 hours ago - Sports

The potential GOAT of chess faces intriguing challenger

Illustration: Sarah Grillo/Axios

The World Chess Championship between Norway's Magnus Carlsen and Russia's Ian Nepomniachtchi began on Friday, 1,094 days after Carlsen won his fourth consecutive title.

Why it matters: During the long, COVID-fueled layoff, chess entered a new era, and with the championship finally here, the age-old game is ready for its close-up.

Department of Interior proposes raising cost of drilling on public lands

A horizontal drilling rig and a pump jack sit on federal land in Lea County, New Mexico. Photo: Callaghan O'Hare/Bloomberg via Getty Images

Oil and gas companies should pay more to drill on federal lands and waters, the Department of the Interior argued in a report released Friday, saying that the current rates were "outdated."

Driving the news: The Department of Interior report said that the federal government's oil and gas leasing and permitting program "fails to provide a fair return to taxpayers, even before factoring in the resulting climate-related costs that must be borne by taxpayers."