A growing number of employers and insurance designers are offering low-wage employees insurance plans that omit outpatient surgery as part of their ACA-mandated coverage, leaving some patients with sky-high medical bills.

The trend is the latest way large employers are attempting to lower their benefits costs, after efforts to offer "skinny plans" excluding inpatient hospital services were rejected by federal regulators last year, according to the report by The Washington Post and Kaiser Health News.

Under the Affordable Care Act, large corporations are required to provide employees with "minimum-value" plans — similar to the Bronze-level plans offered on Obamacare — or face fines of up to $3,000 per employee. In 2015, employers tried to skirt this rule by offering plans that covered basic preventative care, but excluded inpatient hospital services. After federal regulators ruled that inpatient services were required under the ACA, employers and insurers started cutting outpatient procedure coverage instead.

Typically the corporations offering these plans are low-wage industries, like staffing firms, restaurant chains and hotel corporations, the Post reports. These employees may have never had medical coverage before and often jump at the opportunity to purchase cheap insurance in order to avoid fines under the ACA's individual mandate.

However, some employees aren't aware of the lack of coverage for outpatient procedures until it's too late, leaving them with devastating medical bills, the report says. If employees do want to purchase better alternative coverage, they face another problem: They cannot receive federal subsidies to help pay for the supplemental insurance since their employer already offers coverage.

Some experts are questioning the legality of these plans, with several noting that it's unlikely the federal government will allow corporations to continue providing the bare-bones coverage.

"I really wonder whether they can do that," Timothy Jost, a law professor at Washington and Lee University in Virginia, who is an authority on the health law, told the Post. "Refusing to cover any outpatient physician surgical services is arguably a violation."

Several groups, including the American Hospital Association and the Ambulatory Surgery Center Association, are also speaking out against the plans, noting that it leaves patients in a vulnerable position and will end up costing insurers more in the long run.

"Any company that purports to provide health coverage to its employees but doesn't provide for outpatient surgical care is, at best, being penny-wise and pound-foolish," William Prentice, ASCA chief executive officer, told Outpatient Surgery. "The cost-effective care that ASCs provide should be a benefit in every health insurance plan."

Kendal Gapinski