In a nutshell, it has significantly increased the percentage that patients owe of allowed reimbursement amounts. For example, subscriber deductibles, copays, or coinsurances are often higher than what they were before Obamacare. So, insurance companies are not paying as much of their allowed amounts as they were prior to Obamacare, and patients are not paying all of the high patient liabilities assessed by the insurance companies either. This results in hospitals sending more of their patient liability to bad debt, which is often either negotiated down or simply goes unpaid.