Partners: Mississippi Center For Justice & Mississippi Coalition for Citizens with Disabilities
Medical debt has become a critical issue for a large number of low and moderate income individuals and families in the United States. Medical debt is the #1 cause of personal bankruptcy in this country. This is not just a problem of the uninsured, who now number nearly 45 million, and the poor. Millions of other people at all income levels have health insurance plans that fail them when they get sick including plans with high premiums and unaffordable deductibles that provide only limited benefits. When health insurance is non-existent or inapplicable, these people either forgo needed health services or incur crushing debt.
Hospital community benefit programs, including those that provide both uninsured and under-insured patients with financial assistance, have become an increasingly critical and necessary part of the nation’s safety net. They are also a tool for addressing public health problems. The expectation that hospitals will provide these programs and services arises from a number of sources. In the case of nonprofit hospitals, the obligation is rooted in their tax-exempt status. Nonprofit hospitals receive billions of dollars in federal, state and local tax breaks every year and, in exchange, are expected to provide benefits that address the health care needs of the broader communities they serve.
Despite these obligations, research shows that nonprofit hospitals are increasingly engaging in egregious financial practices that push people with inadequate coverage into serious debt. These hospitals’ practices include:
- Charging self-pay patients, on average, three times more for services than the amounts charged to patients with private insurance or covered by public programs;
- Failing to screen uninsured and under-insured patients for eligibility for public or hospital financial assistance programs and then failing to provide them with enrollment assistance;
- Requiring significant up-front payments before providing treatment;
- Mounting extremely aggressive collection practices, including placing liens on patients’ property or garnishing their wages; and
- Selling off patient accounts to third party lenders that charge exorbitant interest rates.
Community Catalyst’s Hospital Accountability Project is working with state and local health care advocates across the country. In Mississippi our partners are Mississippi Coalition for Citizens with Disabilities and the Mississippi Center for Justice. The project’s goal is to improve hospital practices so that uninsured and under-insured people are neither weighted down by medical debt nor dissuaded from seeking health care services. To support this state and local work, Community Catalyst is administering funds from a cypress award realized from the court settlement of a major class action lawsuit against Tenet Hospital Corporation to coalitions of advocacy groups in 15 states. Community Catalyst supports these state and local advocacy efforts with policy expertise, advocacy tools and services.
The Hospital Accountability Project also works at the national level to promote public policies that set clear community benefit and financial assistance standards for hospitals and that establish strong consumer protection practices in billing.
Are you one of many Mississippians who has no medical, dental or vision coverage or your coverage is very limited? Check out MS Community Health Care Centers
Because they exist to serve their communities, Community Health Centers are committed to seeking and combining resources from a variety of sources to ensure that access to primary health care services is made available to all community residents, regardless of their financial or insurance status. Patients who can afford to pay are expected to pay. Medicare and Medicaid patients are always welcome, and insurance companies are billed on behalf of patients with coverage. Each Center’s Board and staff also work to obtain support from other sources, such as government and foundation grants, to ensure that care is available for all patients.
Federally subsidized Health Centers must, by law, serve populations that are identified by the Public Health Services as medically underserved. This status may be related to the fact that they live in geographic areas where there are few medical resources. Poverty, lack of health insurance, and special needs, such as homelessness, AIDS, or substance abuse may be other reasons why people are recognized as medically underserved. Generally, fifty percent (50%) of Health Center patients have neither private nor public insurance.