👋🏾 HI, HEY, HELLO! Welcome back to Congress Nerd Daily. I hope today was everything for you. The midterms are in 7 days.
FIRST THINGS FIRST
One of the nation’s largest hospital chains says more patients are showing up without health insurance, costing it hundreds of millions of dollars for the second consecutive quarter.
HCA Healthcare reported today that more uninsured patients reduced its third-quarter pretax income by about $400 million. The company attributed the shift primarily to patients who lost coverage through Affordable Care Act marketplaces.
The losses come despite HCA reporting $19.85 billion in quarterly revenue, up 3.6% from a year earlier. Net income fell 3.9% to $1.58 billion.
HCA reported a similar $400 million hit in the second quarter, suggesting hospitals are finding it harder to absorb the financial consequences of declining insurance coverage.
The numbers also add another dimension to Washington’s health care debate.
The enhanced ACA premium tax credits expired at the end of last year, making marketplace coverage more expensive for many Americans. HCA identified the expiration and other federal policy changes as risks affecting its business, though it did not isolate how much each contributed to the latest losses.
The earnings offer a reminder that the consequences of people losing coverage extend beyond their household budgets: Hospitals still treat uninsured patients, but they just collect less money for that care.
VIEW FROM THE HILL
President Donald Trump’s mass deportation campaign has become a political liability for Republicans ahead of next week’s midterm elections, according to new polling that reveals a sharp decline in public approval of his immigration policies, growing concern about the economic consequences of deportations and broad support for a pathway to citizenship.
Trump’s net approval on immigration has fallen from a positive 10 points at the start of his second term to negative 12, according to polling averages Elliott Morris, founder of Wave Polling and Research, presented this afternoon. Democrats now hold a narrow two-point advantage over Republicans on which party Americans trust to handle immigration, reversing a 12-point Republican lead last May.
Morris told me political leaders in Washington are underestimating how much backlash against federal immigration enforcement has shaped the changing political environment, even as affordability remains voters’ top concern.
“I think people in Washington, D.C. generally underestimate how important immigration backlash was to putting Democrats in a position where they might even win the Senate and the House,” Morris said.
