Email (excerpted), response to PolitiFact Texas, Kathleen Stoll, director of Health Policy, Families USA, Washington, April 10, 2013

11:57 am

We first identify the total bills charged to the uninsured that were not paid by the insured themselves (about one-third to the total bills), and that were not paid by any other sources like charity care programs or smaller local or state programs or Medicaid DSH, We then "discount" or reduce the total bills charged that have not been paid by .49 (49 percent). This is a payment-to-charge ratio that is derived from MEPS-HC and employer survey data. It better reflects the portion of the total bills that a hospital or other provider would need to shift through the system to operate at the same margins as they do when the set charges for services that are covered by insurance reimbursement.

We do not shift the full total of unpaid bills for care for the uninsured - we assume that a little less than have (49 percent) is shifted to insured rates.

Hope this helps!

Kathleen D. Stoll

Deputy Executive Director

Director of Health Policy

Families USA