Bill would let hospitals conduct income means test for charity care

Maine lawmakers are considering a measure that would align state law regarding eligibility for charity care with the Affordable Care Act by allowing hospitals to conduct an income means test.

Hospitals would not be able to refuse care, but could consider a patient's assets, as well as their income in determining whether those without insurance could pay all or part of their bill, the Maine Sun Journal reported.

The state now requires hospitals to provide charity care to uninsured patients earning less than 150 percent of the federal poverty level, or $17,213. The ACA will provide subsidies for patients to buy insurance if they earn more than 133 percent of federal poverty level, of $15,282, the Sun Journal noted.

The Maine Hospital Association recommended against state law requiring them to provide free care to people who under federal law will be required to buy insurance.

Maine is not the only state discussing how to deal with federal healthcare reform. California lawmakers, for example, are debating Assembly Bill 975, which would mandate 8 percent in charity care spending by hospitals.

The California Hospital Association is fighting the measure, which it says "circumvents community collaboration by prescribing a one-size-fits-all mandate on local community hospitals," according to a commentary in the Capitol Weekly.

The law would "undermine implementation of the ACA and penalize community hospitals during the transitional years ahead," CHA President and CEO C. Duane Dauner wrote in the commentary.

The American Hospital Association, meanwhile, is asking the Internal Revenue Service for flexibility in how not-for-profit hospitals screen patients for financial assistance eligibility. The hospitals also are asking any new regulations be delayed until at least 2014, to coincide with the expansion of Medicaid and the health insurance exchanges mandated under the ACA.

To learn more:
- here's the Sun Journal report
- read the California Hospital Association commentary