More than 27 million Americans do not have health insurance of any kind. A further 43% of non-elderly adults have inadequate insurance, which may have high deductibles or other significant out-of-pocket costs. In the meantime, health care costs and rates of medical debt continue to rise. It is more important than ever for states to require that all hospitals provide comprehensive financial assistance for hospital care.
The Affordable Care Act requires nonprofit hospitals with 501(c)(3) tax-exempt status to provide certain community benefits, including financial assistance for low-income patients. Requirements under 26 CFR §1.501(r) (“501(r)” include establishing a written Financial Assistance Policy (FAP) and a written Emergency Medical Care Policy. However, these requirements apply only to nonprofit hospitals, and the ACA and its implementing regulations do not specify minimum standards or eligibility criteria for this financial assistance. If a nonprofit hospital fails to comply with these requirements, the patient does not have a private right of action under the statute to seek redress for noncompliance, as only the IRS can enforce these requirements.