Charity care can help eligible Arizonans with medical bills amid Medicaid changes

by Sophia Braccio, Cronkite News
March 18, 2026

PHOENIX — Anthony Robinson, 44, said he was shocked when he received two hospital bills totalling over $8,000 for kidney stones treatment. The total was after insurance was applied. He began to think about the changes he would need to make in his life to pay.

Robinson had not heard of hospital financial assistance policies for essential care, sometimes called charity care, but he asked his hospital network, Dignity Health, if they had any programs that could help.

He submitted a financial assistance application in December, assuming the hospital would only be able to forgive a portion of what was owed. In January, his total bill was waived.

“To get 100% of a bill is a blessing,” Robinson said. 

Nonprofit hospitals, such as Dignity Health, are required to establish written financial assistance policies for essential medical services as part of Section 501(r)(4) of the Internal Revenue Code. The law was enacted in 2010 as part of the Affordable Care Act, with more detailed requirements added in 2014.

In 2024, Arizona hospitals forgave over $324 million in charity care, according to a report by Arizona Health Care Cost Containment System, the state’s Medicaid agency, that outlines fiscal performance of the state hospitals.

According to the document, charity care makes up a portion of hospitals’ total uncompensated care, which also includes bad debt. This number has been rising in Arizona, with past reports showing a $213.2 million increase in total uncompensated care from 2015 to 2024.

As some Arizonans brace for the effects of Medicaid changes, more patients across the state could rely on hospital financial assistance, according to James Hodge, a professor at Arizona State University’s Sandra Day O’Connor College of Law.

“We’re going to be needing considerably greater charity care for the long term if we’re even remotely going to provide care for Arizonans,” Hodge said.

Nonprofit hospitals, as well as many for-profit ones, offer charity care for uninsured or under-insured patients who qualify. Policies vary across hospitals and are based on factors including income, household size and how old the bill is.

For many hospitals, patients must also exhaust other financial aid options before receiving charity care. Other potential eligibility factors include residency, citizenship status and if the care received was in-network. All requirements are laid out in a hospital’s financial assistance policy, and if a patient is approved, hospitals might forgive medical debt partially or fully. 

According to Ann-Marie Alameddin, president and CEO of the Arizona Hospital and Healthcare Association, the ACA standardized charity care for nonprofit hospitals, but hospitals have a longstanding tradition of providing care for free or at a reduced cost.

“It’s really a part of the hospital’s mission to care for their communities, no matter someone’s ability to pay,” Alameddin said.

Some states have specific laws and stricter requirements regulating hospitals’ charity care criteria, minimum charity care spending and windows of acceptance for applications for assistance. Because Arizona does not, all charity care falls under federal policy, which requires hospitals “widely publicize” their financial assistance programs. 

However, not all patients are aware of these policies, according to a 2023 survey by Dollar For, a nonprofit that helps people file charity care applications across the U.S. and supports policies “to make hospital financial assistance work as it was intended.” Of those surveyed, 51% who were potentially eligible for assistance did not apply. 

More than half of those who didn’t apply cited not knowing about financial assistance as their reason, according to the survey. 

Dollar For founder Jared Walker said it can also be difficult for patients to remember their financial assistance options when they are moving in and out of the hospital and dealing with their personal health.

“A lot of patients leave the hospitals without knowing about the program at all,” said Walker, who believes hospitals could put more effort into educating patients on their financial assistance options.

According to Alameddin, financial assistance policies and application forms are available in Arizona hospitals and online and often come up in conversations within the health care setting.

Arizona hospitals are entering a “perfect storm,” Alameddin said, referring to a combination of lost hospital funding and Medicaid cuts.

Alameddin said it is likely the number of uninsured Arizonans will rise due to the expiration of ACA enhanced premium tax credits earlier this year and new Medicaid work requirements. In addition, “hospitals’ ability to absorb those costs of care is going to be constricted going forward because the One Big Beautiful Bill that was passed in July is reducing a really important funding source for hospitals through supplemental payments,” Alameddin said. She’s referring to significant reduction of Medicaid’s State-Directed Payments that are used to finance public and safety-net hospitals, among others.

According to Hodge, this increase in patient need and decrease in hospital revenue could mean tough decisions, especially for small, rural hospitals in Arizona.

“They start cutting the services they can that are the least profitable or least serviceable possible,” Hodge said, referring to services such as labor and delivery. “They can’t operate like that long term. They know it. They’re cutting costs. Last resort – they close doors.”

Walker said Dollar For is already seeing an increase in inquiries from other nonprofits who support patients, looking for ways they can help them access assistance with hospital bills.

“I always tell people, ‘It’s so easy to see if you’re eligible. It’s so easy to check,’” Walker said. “A lot of times people just assume that they’re not eligible. They kind of disqualify themselves.”

This <a target=”_blank” href=”https://cronkitenews.azpbs.org/2026/03/18/hospital-financial-assistance-policies-help-arizona-patients/”>article</a> first appeared on <a target=”_blank” href=”https://cronkitenews.azpbs.org”>Cronkite News</a> and is republished here under a <a target=”_blank” href=”https://creativecommons.org/licenses/by-nd/4.0/”>Creative Commons Attribution-NoDerivatives 4.0 International License</a>.<img src=”https://i0.wp.com/cronkitenews.azpbs.org/wp-content/uploads/2026/02/favicon1.png?resize=85%2C85&amp;ssl=1″ style=”width:1em;height:1em;margin-left:10px;”>

<img id=”republication-tracker-tool-source” src=”https://cronkitenews.azpbs.org/?republication-pixel=true&post=100844″ style=”width:1px;height:1px;”><script> PARSELY = { autotrack: false, onload: function() { PARSELY.beacon.trackPageView({ url: “https://cronkitenews.azpbs.org/2026/03/18/hospital-financial-assistance-policies-help-arizona-patients/”, urlref: window.location.href }); } } </script> <script id=”parsely-cfg” src=”//cdn.parsely.com/keys/cronkitenews.azpbs.org/p.js”></script>

Canonical Tag:



Copy Tag

Article Content:

As Arizona braces for Medicaid reforms, many patients don’t know how to qualify for hospital debt forgiveness</p> <p>Sophia Braccio, Cronkite News<br /> March 18, 2026</p> <p>PHOENIX — Anthony Robinson, 44, said he was shocked when he received two hospital bills totalling over $8,000 for kidney stones treatment. The total was after insurance was applied. He began to think about the changes he would need to make in his life to pay.</p> <p>Robinson had not heard of hospital financial assistance policies for essential care, sometimes called charity care, but he asked his hospital network, Dignity Health, if they had any programs that could help.</p> <p>He submitted a financial assistance application in December, assuming the hospital would only be able to forgive a portion of what was owed. In January, his total bill was waived.</p> <p>“To get 100% of a bill is a blessing,” Robinson said. </p> <p>Nonprofit hospitals, such as Dignity Health, are required to establish written financial assistance policies for essential medical services as part of Section 501(r)(4) of the Internal Revenue Code. The law was enacted in 2010 as part of the Affordable Care Act, with more detailed requirements added in 2014.</p> <p>In 2024, Arizona hospitals forgave over $324 million in charity care, according to a report by Arizona Health Care Cost Containment System, the state’s Medicaid agency, that outlines fiscal performance of the state hospitals.</p> <p>According to the document, charity care makes up a portion of hospitals’ total uncompensated care, which also includes bad debt. This number has been rising in Arizona, with past reports showing a $213.2 million increase in total uncompensated care from 2015 to 2024.</p> <p>As some Arizonans brace for the effects of Medicaid changes, more patients across the state could rely on hospital financial assistance, according to James Hodge, a professor at Arizona State University’s Sandra Day O’Connor College of Law.</p> <p>“We’re going to be needing considerably greater charity care for the long term if we’re even remotely going to provide care for Arizonans,” Hodge said.</p> <p>Nonprofit hospitals, as well as many for-profit ones, offer charity care for uninsured or under-insured patients who qualify. Policies vary across hospitals and are based on factors including income, household size and how old the bill is.</p> <p>For many hospitals, patients must also exhaust other financial aid options before receiving charity care. Other potential eligibility factors include residency, citizenship status and if the care received was in-network. All requirements are laid out in a hospital’s financial assistance policy, and if a patient is approved, hospitals might forgive medical debt partially or fully. </p> <p>According to Ann-Marie Alameddin, president and CEO of the Arizona Hospital and Healthcare Association, the ACA standardized charity care for nonprofit hospitals, but hospitals have a longstanding tradition of providing care for free or at a reduced cost.</p> <p>“It’s really a part of the hospital’s mission to care for their communities, no matter someone’s ability to pay,” Alameddin said.</p> <p>Some states have specific laws and stricter requirements regulating hospitals’ charity care criteria, minimum charity care spending and windows of acceptance for applications for assistance. Because Arizona does not, all charity care falls under federal policy, which requires hospitals “widely publicize” their financial assistance programs. </p> <p>However, not all patients are aware of these policies, according to a 2023 survey by Dollar For, a nonprofit that helps people file charity care applications across the U.S. and supports policies “to make hospital financial assistance work as it was intended.” Of those surveyed, 51% who were potentially eligible for assistance did not apply. </p> <p>More than half of those who didn’t apply cited not knowing about financial assistance as their reason, according to the survey. </p> <p>Dollar For founder Jared Walker said it can also be difficult for patients to remember their financial assistance options when they are moving in and out of the hospital and dealing with their personal health.</p> <p>“A lot of patients leave the hospitals without knowing about the program at all,” said Walker, who believes hospitals could put more effort into educating patients on their financial assistance options.</p> <p>According to Alameddin, financial assistance policies and application forms are available in Arizona hospitals and online and often come up in conversations within the health care setting.</p> <p>Arizona hospitals are entering a “perfect storm,” Alameddin said, referring to a combination of lost hospital funding and Medicaid cuts.</p> <p>Alameddin said it is likely the number of uninsured Arizonans will rise due to the expiration of ACA enhanced premium tax credits earlier this year and new Medicaid work requirements. In addition, “hospitals’ ability to absorb those costs of care is going to be constricted going forward because the One Big Beautiful Bill that was passed in July is reducing a really important funding source for hospitals through supplemental payments,” Alameddin said. She’s referring to significant reduction of Medicaid’s State-Directed Payments that are used to finance public and safety-net hospitals, among others.</p> <p>According to Hodge, this increase in patient need and decrease in hospital revenue could mean tough decisions, especially for small, rural hospitals in Arizona.</p> <p>“They start cutting the services they can that are the least profitable or least serviceable possible,” Hodge said, referring to services such as labor and delivery. “They can’t operate like that long term. They know it. They’re cutting costs. Last resort – they close doors.”</p> <p>Walker said Dollar For is already seeing an increase in inquiries from other nonprofits who support patients, looking for ways they can help them access assistance with hospital bills.</p> <p>“I always tell people, ‘It’s so easy to see if you’re eligible. It’s so easy to check,’” Walker said. “A lot of times people just assume that they’re not eligible. They kind of disqualify themselves.”</p> <p>This article first appeared on Cronkite News and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Copy Content

Tracking snippet:



Copy Snippet