Stack of cash dollars and stethoscope on blue background. Concept of medical strechevka or expensive medicines, doctor's salary.
Jacqueline Powers is an intern at the Lown Institute and an undergraduate student at Tufts University.as an intern Hospital billing and collection practices She studied state-level policies regarding financial aid eligibility.
Let's say you earn $21,870 a year, or 150% of the Federal Poverty Level (FPL), and you come to the hospital for treatment. Are you eligible for financial aid to help with these costs? It depends on where you live.
If you live in Rhode Island, you'll be covered in full thanks to a state law that requires hospitals to provide free treatment to patients with up to 200% FPL. However, if you live in Arkansas, financial aid is not guaranteed.
Additionally, many states use other factors besides income to determine eligibility, such as hospital type, insurance status, residence, and type of service. For example, Indiana provides free treatment only to eligible individuals whose condition is serious enough that without medical attention they would die or be severely disabled. There is clear variation across states in financial aid policy decisions.
Health care services are expensive, and financial aid policies influence whether individuals can afford them. However, there are no federal standards for income-based eligibility, and only some states have their own requirements. This creates a patchwork of policies, with some states requiring more generous policies than others. For example, to qualify for discounted treatment in Connecticut, a patient must be uninsured and have a household income less than 250% of her FPL. This is a low threshold when compared to other states such as California, Oregon, and Washington, which mandate free or discounted care for most individuals with incomes below 400% of her FPL. is.
What explains policy differences between states? One might think that it is because the cost of living and income levels vary widely across countries. But I'm not convinced this is the main reason. According to Forbes magazine, Hawaii has the highest cost of living and lowest disposable income in the country. Surprisingly, Hawaii has no requirements for hospital financial aid policies.
A clearer comparison is between Massachusetts, which ranks 2nd with the highest cost of living, and Oklahoma, which ranks 47th. Massachusetts policy states that a patient is eligible for free treatment if her FPL is less than 150% of her FPL and is eligible for discounted treatment if her FPL is less than 300% of her FPL. Masu. Oklahoma also has a required discount if a patient whose income is less than 300% of her FPL is uninsured. It is shocking to me that two states with such different costs of living and income levels have the same financial aid limits. This suggests to me that cost of living is not the primary consideration in these policies, and that states have other motivations. First, in states where welfare is a divisive topic, political obstacles may prevent generous funding from being sought.
I feel we need to put more pressure on states to develop fair financial aid policies. Not providing financial assistance in hospitals can push people away from seeking treatment and lead to poorer health outcomes that disproportionately impact low-income people. Everyone should have the right to health care, and national funding policies are an opportunity to expand health equity. States have a responsibility to keep their populations healthy, regardless of their ability to pay.
Written by Jacqueline Powers