State legislation doesn't pass, but hospitals still act

As one of only a few states that require hospitals to provide charity care, Washington state has had a charity care law on the books since 1989. In 2006, the state legislature took another look at the issue.

"There was concern that although we did have a law on the books, it wasn't sufficient," says Jonathan Seib, a policy advisor to Governor Chris Gregoire in Olympia. "There was dismay over reports of what uninsured patients were being charged and the financial burdens that were being placed on people."

In the end, the legislation, which would have required hospitals to adhere to specific standards for charity care, didn't pass. However, the attention called to the issue achieved a very similar result. The state hospital association adopted, on a voluntary basis, a set of principles to guide its charity care.

The new voluntary guidelines cover uninsured patients up to 300% of the federal poverty level (FPL). All patients who document income at the FPL receive free care. Those who document income between 100% and 200% of FPL will not be asked to pay more than an amount representing the cost of care. All patients who document their income at between 200% and 300% of FPL also qualify for a discount and pay an amount no more than what an insured patient would pay.

There also is a provision requiring hospitals to increase their oversight of collection policy, and to provide information to patients about financial assistance.

"All that was done voluntarily in response to a big push to enhance the existing charity care law," says Mr. Seib. (Editor's note: To see the State Hospital Association's charity policy, go to:

Contact Mr. Seib at (360) 902-0557 or