Should hospitals provide charity care to those who decline health coverage?

Some hospitals across the country are scaling back their charity care programs to help encourage those who qualify to sign up for coverage under the Patient Protection and Affordable Care Act, according to a report by Kaiser Health News.

At Southern New Hampshire Medical Center in Nashua, patients who qualify for coverage under the PPACA but refuse to purchase the health insurance are no longer eligible to receive charity care.

At St. Louis-based BJC HealthCare — a 12-hospital system with facilities in Illinois and Missouri — all patients must contribute to the cost of their care, such as paying $100 towards a visit to the emergency department, regardless of their income level. BJC still offers charity care to those who refuse to purchase insurance under the PPACA, but the system has altered its assistance policy. BJC offers a 25 percent discount on services to patients earning up to three times the federal poverty level, while the system formerly offered the discount to patients making up to four times the poverty level, according to the report.

Even with the uninsured rate on the decline, Michael Miller, director of strategic policy at Boston-based advocacy group Community Catalyst, believes there is still a need for financial assistance programs at hospitals. He also disagrees with the reasoning behind altering financial assistance programs. He believes people will still purchase insurance if charity care is provided, as many of the uninsured require medical services outside of the hospital setting.

While some healthcare providers have already made changes to their charity care policies, others, including St. Louis-based Ascension Health, are still evaluating whether to make any changes. The health system has put together a special task force to address the issue and make a recommendation by the end of this year, according to the report.

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