Well, one of the costs they are offsetting is that of indigents and illegals receiving primary care in hospital emergency rooms on a (like it or not) pro bono basis. It must mount up somewhere, because as a sector health care facilities don't show huge profit margins compared to pharmaceuticals (license to print money) or biotechnology (license to print money in large denominations).
Still, it must be noted that the ACA is an attempt (how effective we shall see) to stop the entirely pro bono care in emergency rooms in favor of complete health coverage and increased preventative care.
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