Hospitals challenge free non-emergency health care for non-Washingtonians



(The Center Square) – Washington hospitals want the courts to stop a state mandate that they must give patients from anywhere in the world free non-emergency care.

The Washington State Hospital Association filed a lawsuit in Thurston County Superior Court challenging the state Dept. of Health’s edict saying hospitals must offer non-emergency care to anyone in order to keep their nonprofit status. For decades, the state has allowed hospitals to only offer emergency care to “indigent persons” who need it and restrict non-emergency care to residents of the state or the hospital’s geographic area. DOH changed the requirement in September.

“The new interpretation dramatically departs from more than three decades of established practice based on the state’s current charity care law and now bars hospitals from implementing charity care policies with any geographic limit,” said Taya Briley, executive vice president and general counsel for the hospital association. “Instead, it requires hospitals to provide free or discounted care to anyone from anywhere. The new approach would make Washington State a medical tourism destination.”

Currently, mid-size and larger hospitals give free or discounted care for patients making up to 400% of the federal poverty level, or $58,000 for an individual and $120,000 for a family of four. Smaller hospitals, most often in rural areas, give free or discounted service to those making up to 300% of the federal poverty level, or about $43,000 for an individual and $90,000 for a family of four. Certain exceptions apply to what is considered assets when qualifying patients for free care, such as home value, low-dollar insurance or owned vehicles used for employment.

Association CEO Cassie Sauer said Monday that the influx of newly qualified care seekers would put a strain on the state’s already stretched hospital system and make a visit more expensive for patients who can pay.

“There is no such thing as free care. Nurses, physicians, pharmacists, housekeepers and other staff who care for charity care patients still must be paid,” Sauer said. “Under the department’s interpretation, people living in Washington will subsidize charity care services to people from outside of the state.”

In its September proposal, DOH said a law signed by Gov. Jay Inslee in March 2022 means hospitals “shall not be based, in whole or in part, on an indigent person’s residency.”

The hospitals are seeking a ruling before the change takes effect on Jan. 16, 2024.

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