A hospital stay is no fun to begin with, and the bill you get later can quite literally add insult to injury- especially if you are uninsured.
This was the reality for Robert*, a man who called CCHI in November after having undergone emergency surgery during a gap in health coverage. The hospital had billed him for more than $25,000- far more than he and his wife could afford to pay.
Robert’s experience is not uncommon. Without the bargaining power of large insurance companies, uninsured patients have long been stuck with astronomically high bills. Since there is no one to negotiate costs with the hospital on their behalf, they often pay prices that are higher than what the hospital charges the insurance company of someone with coverage.
These bills are especially burdensome because many of Colorado’s 829,000 uninsured are very low-income: nearly 60% fall below 133% of the Federal Poverty Level (FPL), or a salary of about $15,000 per year for an individual. Faced with a huge, complex medical bill that they simply cannot pay, these patients often go into medical debt.
The Hospital Payment Assistance program is beginning to change that. The law, passed last May, requires that hospitals:
- Provide information about all available charity care and financial assistance programs online, in patient bills, and in the hospital itself.
- Screen uninsured patients for all discount programs, including the new Hospital Payment Assistance Program, under which uninsured patients who are below 250% FPL (about $28,000 per year for an individual and about $57,000 per year for a family of four) cannot be charged more than the lowest negotiated rate the hospital would charge an insurer.
- Take certain actions before sending a bill to collections, including waiting 30 days after a patient’s first missed payment, and offering reasonable payment plans.
Fortunately, Robert was aware of the Hospital Payment Assistance Program, and after negotiating with the hospital and insisting that they comply with the law, his bill was reduced from $25,000 to $600 — a discount of more than 97%.
However, not all uninsured patients are so lucky. Since the law took effect last August, CCHI has been monitoring hospitals’ implementation of the Hospital Payment Assistance Program. While many more hospitals have begun providing information about their charity care programs online, much of this information is incomplete. Additionally, CCHI has received a number of calls from uninsured consumers who were given no information — in bills, in-person communications, online, or otherwise — about any form of financial assistance.
The Hospital Payment Assistance Program is making progress toward fairer billing practices and a real difference in the lives of uninsured Coloradans. However, there is still work to be done. It is imperative that hospitals follow the law and provide uninsured Coloradans with the resources they need to pay their bills responsibly. All Coloradans should have access to the care they need, and together, with the help of the Hospital Payment Assistance Program, we can move our state toward this commonsense goal.
Do you have a story like Robert’s? If you are uninsured have had unaffordable hospital bills, we want to hear from you! Make your voice heard, and share your story today!
* The actual name of this consumer has been changed to protect his privacy.