According to a new survey conducted by WPA Intelligence for TPPF, the vast majority of Texans have no idea what charity care is or that it could be an important solution to providing health care for low-income patients.
Every non-profit hospital is required by Section 501 (r) of the federal tax code to set forth a “financial assistance policy” that established a charity care program that offers free or discounted care to low-income patients. In exchange for providing this benefit, non-profit hospitals are exempt from paying state, local, and federal taxes. In 2021, the total value across the U.S. for non-profit hospitals was estimated to be over $25.7 billion; this is enough money to pay off all medical debt in Texas, California, New York, and Pennsylvania combined.
Considering that over 50 percent of hospitals in the U.S. are non-profit, charity care should be accessible to millions of Americans. However, recent reports suggest that patients are not financially benefiting from this program. The Kaiser Family Foundation found that at half of reporting hospitals, charity care accounts for only 1.4 percent or less of operating expenses.
Other states have started reviewing their charity care programs after discovering certain non-profit hospitals have been sending charity care eligible patients to debt collections.
This national trend of patients being unaware of charity care has made its way to Texas. The WPAi study showed that only half of Texans (48%) say they are aware of charity care, and only around 1 in 4 of that group can correctly identify what the program does. In all, 87% of Texans are either unaware of charity care or don’t know that it requires certain hospitals to provide free or reduced-cost health care for low-income patients.
The lack of awareness when it comes to charity care is not surprising in Texas since non-profit hospitals are only required to run a print newspaper ad in the community paper and post signs in a conspicuous place in their lobby according to Section 311 of the Texas Health and Safety Code.
Non-profit hospitals play a key role in their communities and are the first line of defense in the social safety net. At a time when the Texas state legislatures is being pressured to expand Medicaid – a multi-billion-dollar mistake that would bust state budgets – enforcing the requirements of non-profit hospitals to provide charity care could be a significant solution for the uninsured.
The poll surveyed 801 registered voters in Texas from February 1-4, 2025 and has a margin of error of +/- 3.5%>”
