Courtesy Oregon Association of Hospitals and Health Systems
Courtesy Oregon Association of Hospitals and Health Systems
Charity care from Oregon hospitals dropped sharply starting in 2014, the year the Affordable Care Act went into effect. About 430,000 patients who previously might have received free or low-cost care from hospitals now had coverage because Oregon embraced the ACA so firmly.

Charity care numbers had peaked in 2013, with the state’s hospitals providing almost $383 million. By 2016, the figure dipped to about $150 million as more and more people found coverage.

Oregon hospitals have long been tax-exempt because of the benefit they provide to society. But when some state lawmakers saw the charity care numbers dip, they began asking if hospitals were getting away with something.

That gave rise to House Bill 3076, which established new charity care criteria for hospitals and clinics. The bill passed 38-21 in the Oregon House and 20-8 in the Oregon Senate. Gov. Kate Brown signed it into law June 25, and it takes effect Jan. 1, 2020.

Under the new law’s provisions, the Oregon Health Authority will work hospital-by-hospital, establishing a minimum amount of free care that each must provide.

Meanwhile, charity care already had begun climbing again on its own, hitting $196 million in 2017 with an expected continued rise when 2018 numbers at tallied. That seems to be because some new health plans with low premiums are leaving a lot uncovered.

“People have coverage but have trouble meeting their part of the bill,” said David Northfield, director of communications for the Oregon Association of Hospitals and Health Systems.

On top of that, the federal government predicted the windfall and so established a series of cuts to what Medicare will pay to hospitals.

As a result, and independent of the new Oregon law, charity care was likely to increase over the next decade.

The hospital association took no position on House Bill 3076, but was in on negotiations to shape it. Providence and PeaceHealth also helped craft the bill and were the only health systems in the state to throw their support behind it.

Last year, Providence in Oregon offered $43.4 million in free and discounted care. PeaceHealth in Oregon gave $35 million.

Northfield says that what hospitals do for society goes beyond charity care. Health providers also organize health fairs, free or low-cost health classes, transportation, spiritual care, internships, research, health studies, childcare for patients and neighborhood revitalization.

In 2017, Oregon’s hospitals provided $2.32 billion in community benefits, according to a report by the association.

Providence alone offered community benefit last year totaling more than $417 million, according to its website.