Hospital charity-care laws dataset — free and discounted care rules in 52 jurisdictions

Name: Hospital charity-care laws by state
Creator: MigrantUSA
License: https://migrantusa.com/terms/

Downloadable dataset of state hospital financial-assistance laws: which states mandate free or discounted care, income thresholds, statutes, and sources.

Hospital charity-care laws dataset

Download: charity_care_states.json · Coverage: 52 jurisdictions · Verified: June 10, 2026 · Refresh: re-verification cadence enforced by automated data-health budget; event-driven updates for law changes

Which states legally require hospitals to provide free or discounted care, at what income thresholds, under which statute — 39 rows verified directly against statute text, the rest against authoritative state-law compilations (sources cited per row).

What’s in each row

Per state: whether a state law exists beyond federal 501(r), the law’s name and citation, free-care and discounted-care income thresholds as % of the federal poverty level, what the law covers, a plain-language summary in English and Spanish, source links, and a confidence flag.

Method

Researched June 2026 from state legislature texts, state health-department pages, the Hilltop Institute’s Community Benefit State Law Profiles, and Dollar For’s state sheets — with statute text as the tiebreaker wherever sources disagreed. Each row stores its own sources.

How often the sources update

None of the sources we checked on October 10, 2026 states an update schedule for these facts. Its facts come from state statutes, which change when a legislature passes a law, and from compilations that are revised when their publishers choose. What the sources themselves showed when we checked on October 10, 2026:

Source	What it says about its own currency
IRS, Requirements for 501(c)(3) hospitals under the ACA, Section 501(r)	“Page Last Reviewed or Updated: 02-Jul-2026”
IRS, Charitable hospitals: general requirements	“Page Last Reviewed or Updated: 02-Jul-2026”
Maine Legislature, 22 M.R.S. §1716-A	“Data for this page extracted on 10/05/2026 17:28:28.”
Hilltop Institute, About the Profiles	“The Profiles were originally published in March 2013.” The latest update it lists: “The third update, published June 2016, identifies changes that occurred between November 1, 2015, and May 31, 2016.”

The Hilltop dates are one reason statute text is the tiebreaker here: a state-law compilation whose latest listed update covers changes through May 2016 cannot show a law passed since then.

Changes since the June 2026 research date

Delaware. As of October 10, 2026, the Delaware Code contains a new Title 16, Chapter 99, Subchapter VII, “Financial Assistance”, tied to 85 Del. Laws, c. 349. Its §9962, “Minimum financial assistance standards”, is marked “Effective Jan. 1, 2027” and requires “Full financial assistance for medically necessary hospital services for financially qualified patients with household income at or below 300% of the federal poverty level”, with discounts of no less than 75% between 300% and 350% and no less than 50% between 350% and 400%. A contingent version of §9311 would point hospitals to those requirements. The Delaware row’s thresholds and summary still describe the current Certificate of Public Review rule; its note records §9962 as read on October 10, 2026; see the Delaware free hospital care page for the state’s current rule.
Maine. The Maine Legislature’s page for 22 M.R.S. §1716-A (data extracted October 5, 2026) states: “A hospital shall provide free, medically necessary services for patients whose family income is equal to or less than 200% of the federal poverty level.” That matches the Maine row. See the Maine free hospital care page.

How this dataset is built

Rows: 52 — the 50 states, the District of Columbia and Puerto Rico.
State law or not: 27 rows record a state charity-care law beyond federal 501(r); 25 record none, and their plain-language summaries say what applies instead, such as the federal 501(r) rules or a related state or county program.
Fields on every row: has_state_law, sum_en and sum_es (plain-language summaries), sources (links) and confidence.
Fields on the 27 law rows: law, citation, covers, free_pct and disc_pct. The thresholds are the maximum income, as a percentage of the federal poverty guidelines, for mandated free care and for any mandated discount; a null value marks a law for which our June 2026 research found no poverty-level threshold in the statute text. 14 rows set a free-care threshold and 16 set a discount threshold.
Notes: 22 rows carry note_en and note_es, used for exceptions, pending changes and status or residency rules.
Confidence: 39 rows are marked verified and 13 secondary-source-only (Alabama, Alaska, Arizona, Arkansas, Delaware, Hawaii, Idaho, Nebraska, New Hampshire, North Dakota, Oklahoma, Pennsylvania and Puerto Rico).
One research date. All rows share the file’s research date, June 10, 2026. The one exception is the Delaware note, which states its own reading date (October 10, 2026).
What is left out: each hospital’s own financial-assistance policy. The IRS says hospital organizations “must meet the requirements imposed by Section 501(r) on a facility-by-facility basis”, so the policy that applies to a bill is the one of the hospital facility that sent it.

How to use this data — limits

The federal baseline has four parts. The IRS lists the Section 501(r) requirements as the community health needs assessment (501(r)(3)), the financial assistance policy and emergency medical care policy (501(r)(4)), limitation on charges (501(r)(5)) and billing and collections (501(r)(6)); its page notes that “Final regulations were released on December 29, 2014.” This dataset records only what state law adds on top.
Thresholds are poverty-level percentages, not dollar amounts. Converting one to dollars requires the federal poverty guideline for the year and household size.
Laws change between research dates. Delaware, above, is an example. Check the statute link in a row before relying on it.
The sources warn that they are not legal advice. The Hilltop Institute says: “All material produced by Hilltop’s Hospital Community Benefit Program is for informational purposes only and is not legal advice.” The Maine Revisor of Statutes says: “The Revisor’s Office cannot provide legal advice or interpretation of Maine law to the public.”

Where this data is used

Charity-care income thresholds analysis — the 14 free-care income lines charted, 100% to 300% FPL
Free hospital care by state — 104 live pages render from this file

Suggested citation: MigrantUSA, “Hospital charity-care laws dataset,” migrantusa.com/datasets/hospital-charity-care-laws/, retrieved [date].

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This is general information, not legal advice. Each hospital applies its own financial-assistance policy under federal and state rules. Consult an attorney for your specific situation.

Frequently asked questions

What is charity care?

Free or discounted hospital care for patients below income thresholds. Federal law (IRC § 501(r)) requires every nonprofit hospital to have a financial-assistance policy; on top of that, some states mandate specific eligibility thresholds and screening duties by statute. This dataset maps those state laws.

Does immigration status matter for charity care?

The thresholds this dataset records are income tests, stated as a percentage of the federal poverty level. Three rows carry notes about immigration status: the Maryland row notes that its law applies regardless of immigration status, the Illinois row notes that patients who decline public insurance over immigration-status fears still count as uninsured, and the South Carolina row notes that its county-funded program is for citizens and lawful permanent residents only. The New York row’s summary says hospitals cannot consider immigration status. Residency rules are separate: Maine’s law covers state residents, which the statute defines by living in Maine with intent to remain or entering with a job commitment or to seek work. Read each row’s notes for its state.

How current is this dataset?

State laws were researched against legislature texts in June 2026, and every row shares that research date (June 10, 2026); only the Delaware note carries a later reading date (October 10, 2026). The amended Maine and Indiana laws took effect July 1, 2026, and the rows describe those rules. As of October 10, 2026, the Delaware Code shows a new financial-assistance law with minimum standards marked effective January 1, 2027; the Delaware row’s note records it, while its thresholds and summary still describe the current rule.

How often do the sources behind this dataset update?

There is no single publisher. State statutes change when legislatures act, and the official statute pages carry their own stamps: the Maine Legislature’s page for 22 M.R.S. §1716-A says its data was extracted on 10/05/2026, and both IRS pages on hospital requirements say Page Last Reviewed or Updated: 02-Jul-2026. The Hilltop Institute’s state law profiles list their latest update as published June 2016, covering changes through May 31, 2016.

What does the confidence flag mean?

Each row is marked verified (checked against statute or regulation text; 39 rows) or secondary-source-only (checked against a compilation such as Dollar For or Hilltop but not against the statute itself; 13 rows). Treat a secondary-source-only row as a lead to confirm with the state’s own text.

Cite this dataset

Free to use under CC BY 4.0 — share and adapt, with attribution. If it was useful enough to build on, a citation is the whole ask.

MigrantUSA Editorial (2026). Hospital charity-care laws by state, in US Immigration Data. 10.5281/zenodo.21812233

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Permanent DOI (all versions): 10.5281/zenodo.21812233
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Methodology and sources · data updated 2026-06-10

The underlying facts come from the official sources cited inside each file and carry no copyright; what we contribute is the curation, verification, and the banked history. If your claim rests on what a value used to be, cite the government source for the fact and this record for the change.

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General information, not legal advice. MigrantUSA is an independent publisher and is not a law firm; using this site does not create an attorney-client relationship, and this content is not a substitute for advice from a licensed attorney about your specific situation. US federal, state, and local government procedures, fees, and forms change. Always verify current details directly with the relevant agency before acting. For immigration, tax, or other legal matters specific to your situation, consult a licensed attorney or BIA-accredited representative.