New law to offer free or discounted hospital care to 4 million Washingtonians

Starting Friday, four million Washington residents will qualify for free or discounted care at hospitals across the state, giving Washington the strongest protections in the country for out-of-pocket hospital costs. 

Attorney General Bob Ferguson worked with Representatives Tarra Simmons (D-Bremerton), Eileen Cody (D-Seattle) and Nicole Macri (D-Seattle) on House Bill 1616. The bill guarantees free hospital care to one million people who are currently eligible for discounted care, and expands discounted care to an additional one million. 

"This is a landmark achievement for affordable health care," Ferguson said. "Too many Washingtonians are just one hospital bill away from financial crisis." 

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All Washingtonians within three times the federal poverty level are now eligible for financial support. The legislation establishes two tiers of assistance — one for large health care systems, which make up approximately 80% of hospital beds, and another for smaller independent hospitals, which are primarily in rural areas.

Unofficial chart of hospital tiers under HB 1616

For example, a family of four with an income of up to $111,000 will now qualify for up to 50% off their out-of-pocket costs at Tier 1 hospitals. A family of four earning up to $55,500 can now pay zero out-of-pocket costs at any hospital in the state.

Nationwide, about two-thirds of individuals who file for bankruptcy cite medical issues as a key contributor, and more than half of collection items on credit reports are for medical debts. Access to care is also an equity issue, as communities of color are disproportionately underinsured and vulnerable to unexpected medical expenses.

The prior law only provided free care for those earning less than the federal poverty level — $17,420 per year for a two-person household — and sliding scale discounts for those earning up to two times the poverty level. About 1.8 million Washingtonians were previously eligible for financial assistance. 

Affordable hospital care eligibility under HB 1616

"Our new law moves us away from a system where a single mom working two minimum wage jobs didn’t qualify for any help with her hospital bills, to something that offers help to about half the people in Washington," said Ferguson. "It’s the right thing to do."

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Ferguson has filed lawsuits against three Washington hospitals for violating Washington’s Consumer Protection Act by preventing low-income patients from accessing charity care.

Under state law, hospitals are required to:

  • Provide notice of charity care availability both verbally and in writing
  • Screen patients for charity care eligibility before attempting to collect payment
  • Only require patients to provide one income-related document to prove charity care eligibility

"No Washingtonian should be bankrupted by a trip to the emergency room," Simmons said.