Employee-Paid

"Low and middle-income workers rely on those other forms of coverage, because they can't rely on access to employer coverage as companies outsource certain functions to contractors or hire more employees in roles that aren't eligible for benefits," said Dr. Sumit Agarwal, an assistant professor at the University of Michigan Medical School and School of Public Health.

"If the first obligation of a health care system is to take care of the sick, we are failing that test," said Dr. Drew Altman, founding president and CEO of KFF.

The hospital giant's chief financial officer told investors that consumer sentiment is also affecting collections.

Thatch, a company that supports the arrangements formerly known as ICHRAs, has attracted a list of backers that includes ADP.

Producer groups are not sure what kinds of producers a mysterious new batch of guidance might affect.

Until recently, CHOICE plans were known as individual coverage health reimbursement arrangement plans.