14 states set a hard income line for free hospital care — and the lines are 3× apart
The finding: 27 of the 52 US jurisdictions (50 states, DC, and Puerto Rico) have a charity-care law on the books, but only 14 set a hard income threshold below which hospitals must write the bill off entirely — and that line varies threefold, from 100% of the Federal Poverty Guidelines in Ohio and South Carolina ($33,000 for a family of four) to 300% in Washington ($99,000 ). The single most surprising number is Illinois: its statute mandates discounted care up to 600% of poverty — $198,000 a year for a family of four, an income most people would never associate with hospital financial assistance.
What the data shows
- Where you’re hospitalized decides what you owe. The same uninsured patient with the same income can be entitled to a 100% write-off in Washington, a partial discount in Colorado, or nothing beyond the hospital’s own policy in the 25 jurisdictions with no state law.
- The federal floor is procedural, not financial. IRS section 501(r) makes every nonprofit hospital adopt and publish a financial-assistance policy — but it never says how generous the policy must be. The dollar lines all come from state law.
- Immigration status is almost never a condition. Of the 27 statutes verified, only South Carolina’s restricts eligibility to citizens and lawful permanent residents. Maryland’s law states explicitly that it applies regardless of immigration status, and Illinois counts patients who decline public insurance over status fears as uninsured for eligibility purposes.
- The map is still moving. Maine’s new threshold law (22 M.R.S. § 1716-A: free care to 200% FPL) and Indiana’s new policy duties take effect July 1, 2026, and Delaware’s SB 13 is pending — three changes inside one summer.
How to use this if you have a hospital bill
The thresholds above are rights, not favors — but they are claimed through the hospital’s financial-assistance application, usually with a deadline measured from discharge. Our plain-language state-by-state guide walks through who qualifies, what documents to bring, and the exact statute to cite: free and discounted hospital care by state.
Method
Every jurisdiction’s entry was researched against the statute or regulation text on June 10, 2026 — not against news coverage — with the citation stored per row (for example, RCW 70.170.060 for Washington, 210 ILCS 89 for Illinois). Where only secondary sources could confirm a state’s status, the row carries a secondary-source-only confidence flag. The chart on this page is regenerated from the dataset on every site build.
Download the data: charity_care_states.json — all 52 jurisdictions with thresholds, coverage scope, citations, and confidence flags. Schema notes on the dataset page.
Suggested citation: MigrantUSA, “Hospital charity-care income thresholds,” migrantusa.com/datasets/charity-care-income-thresholds/, retrieved [date].
Related
- Free and discounted hospital care by state — the how-to-claim guide, all 52 jurisdictions
- Hospital charity-care laws dataset — schema, method, download
- Community health centers by state — sliding-scale primary care regardless of status