What if You Didn’t Owe That Whole Hospital Bill?
Tips to save money that you are not obligated to pay!
The Accountable Care Act is complicated. It’s got a provision most people don’t know about. And that’s why I’m going to tell you about it. Despite being the law for many years now, it’s kind of big news, if you haven’t heard.
Have you received care from the local not-for-profit hospital? Or an outpatient clinic owned by such a hospital? Did you get a bill? 60% of Americans don’t owe all that money.
It doesn’t matter if you have insurance or not. Your employer paying for that insurance doesn’t have the bill either.
Here’s a quick table from healthcare.gov, illustrating where 100% of the federal poverty line is now (this matters for who is eligible for discounts):
For a family of 4, that $111,000 in annual income to get to the most standard 400% FPL cutoff. It’s not just for people at 100%. It’s for people up to 400% or more.
Not-for-profit hospitals—which is most of them—get massive tax breaks. That not-for-profit status is really pretty sweet. It means they get to run one of the more profitable businesses on earth, but not have to pay taxes. Awesome. Why did they get such a privilege? Well, under the accountable care act, it’s because they agreed to, in order to keep that not-for-profit deal, provide free or reduced price services to people who made 400% or less of the federal poverty line. Many hospitals actually cash in on this by getting even bigger tax breaks by agreeing to take care of an even larger swath of the population at reduced rates.
How about NYU Langone Medical Center in New York? They have agreed to provide free or reduced price care to people who makes 600% or less of the federal poverty line. That is $166,500 for a family of 4. That may be “New-York poor,” but it’s not what we generally think of when we think “eligible for charity care.”
This is not just for the uninsured. It’s even if you have insurance. It’s based on your income and family size. What’s more, they have obligations to advertise this, and to present you with this information, and frankly, they don’t.
The pro tip is that there is an organization that will help you navigate this system without a huge complicated amount of healthcare and economics studies on your part: https://dollarfor.org/
They are a non-profit that makes the process of applying for financial assistance easy.
Why This Works:
There is a law. It is called IRS Regulation 501(r). It’s what lets non-profit hospitals not pay those pesky taxes.
Happy open enrollment everybody! If you end up going to a hospital or hospital-based clinic and it’s not-for-profit, remember to ask about patient assistance programs!
—O. Scott Muir, M.D.
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