According to the Washington State Attorney General’s Office (AGO), 4 million Washingtonians now qualifying for free or discounted care at hospitals across state thanks to legislation passed the state Legislature last year.
Medical debt is a serious issue for many Americans, nationwide about two-thirds of individuals who file for bankruptcy cite medical issues as a key contributor, and more than half of the collection items on credit reports are for medical debts. Access to care is also an equity issue. Communities of color are disproportionately underinsured, and especially vulnerable to catastrophic and unexpected medical expenses.
The AGO claims that this new law significantly increases eligibility for out-of-pocket hospital costs, such as deductibles and co-pays, as well as expanding eligibility for discounts.
Prior to the new law, a single parent working two minimum wage jobs at 50 hours per week was not eligible for financial assistance at hospitals in Washington. The new law changes that and ensures that all Washingtonians within 300 percent of the federal poverty level are eligible for financial assistance on out-of-pocket hospital bills.
Approximately half of all Washingtonians are eligible for free or reduced-cost care at Washington state hospitals, according to the AGO, and the Washington law now provides the strongest protections in the country for out-of-pocket hospital costs.
Families making up to 400 percent of the federal poverty level could be eligible for financial assistance depending on the hospital. The new law establishes two tiers of financial assistance — one for large hospitals and large health care systems (Tier 1) and another for smaller, independent hospitals (Tier 2).
Washington’s new charity care law requires that hospitals make financial assistance available for low-income patients to help with their out-of-pocket medical costs.
In addition, there is no minimum or maximum age requirement for eligibility. Charity care applies to all Washingtonians, whether they have public medical insurance, private medical insurance or are uninsured. Charity care also covers your out-of-pocket costs, regardless of insurance status, based on your income level alone, and all patients can apply for charity care regardless of their immigration status.
“To be clear, we’re talking about people with insurance, not just uninsured folks,” says the AGO. “Many people face significant out-of-pocket costs even with insurance, and our charity care law helps those individuals.
The AGO says that it is important to consumers to know that charity care applies only to the part of the hospital bill that they are responsible for — like deductibles and copays. Medicaid and Medicare will cover their contractual portion of the bills, and then charity care will be applied towards what remains for the patient to pay out-of-pocket.
The AGO has provided the following guidance as it relates to charity care in the state of Washington:
• Charity care applies to medical care received at a hospital. However, sometimes hospitals that are associated with clinics will extend their charity care policy to those clinics. The best thing to do is always ask.
• Charity care applies to medical care received at a hospital. That includes emergency room care at a hospital. It also includes any other scan, test or procedure done at a hospital. Charity care may not cover bills from physicians or other providers not employed by the hospitals.
• Charity care applies to both future care and past bills, as long as they have not been subject to a court judgment. It does not matter how old the bills are, or whether they have been sent to collections. If you are eligible, charity care can apply to your hospital bill.
• Large, urban hospitals that represent 80 percent of hospital beds are in their own tier with more robust discounts. We’re calling these larger hospitals Tier 1, and approximately 3 million Washingtonians will have access to free hospital care at Tier 1 hospitals, and another 1 million will have access to discounted care. The smaller independent hospitals and rural hospitals — which represent only about 20 percent of the beds around the state — are in Tier 2 and offer slightly smaller discounts.
• Only hospitals are required to provide charity care. The statute does not require physician bills to be eligible. However, many hospitals do require that physicians who operate in their Most importantly, hospitals cannot consider your ownership of your primary residence, or its value, when assessing charity care eligibility, so personal home ownership would have no impact on charity care. Hospitals can consider some assets in assessing eligibility, but the thresholds are high and most consumers who are income-qualified for charity care will not be excluded based on their assets.
• Charity care applies to medical care received at a hospital. Eligibility is not determined by specific medical conditions. However, sometimes hospitals that are associated with clinics will extend their charity care policy to those clinics. The best thing to do is always ask.
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