State laws that limit hospital bills for lower-income patients
Several states go further than the federal rules. New Jersey caps bills for uninsured residents below 500% of the federal poverty level at 115% of Medicare; California (up to 400%) and Colorado (up to 250%) cap them at Medicare or Medicaid rates; New York waives them below 200% and caps them at 10–20% of Medicaid up to 400%; Minnesota caps them at the lowest private-insurer rate for household income under $125,000; Connecticut at cost; Illinois, Washington, Oregon, Ohio and Maryland require free or discounted care by income. These limits can be well below a hospital's published cash price, but you usually have to ask and apply.
Checked against the state statutes linked below on 2026-10-04
The laws, state by state
Income limits are a percentage of the federal poverty level for your household size. Each law has its own details on who counts as a resident, which services are covered and which documents a hospital may ask for; the linked text is the authority.
New Jersey
Who: Uninsured NJ residents, family income below 500% of the poverty level.
Limit: At most 115% of what Medicare pays.
Law: P.L.2008, c.60.
California
Who: Uninsured or high medical costs, family income up to 400%.
Limit: At most what the hospital expects from Medicare or Medi-Cal, whichever is greater.
Law: Health and Safety Code §127405.
Colorado
Who: Qualifying patients, household income up to 250%.
Limit: At most the greater of the Medicare rate or the Medicaid base rate; capped monthly payments.
Law: HB21-1198 (Hospital Discounted Care).
Illinois
Who: Uninsured Illinois residents, family income up to 600% (300% at rural and critical access hospitals).
Limit: Discount to about 135% of the hospital's cost; free up to 200% (125% rural); at most 25% of family income in 12 months.
Law: 210 ILCS 89.
New York
Who: Uninsured patients with income up to 400% (underinsured too); emergency care for New York residents, other care for residents of the hospital's service area; immigration status does not count.
Limit: Below 200%, all charges waived; 200–300%, at most 10% of what Medicaid would pay; 301–400%, at most 20%.
Law: Public Health Law §2807-k(9-a), in force since October 20, 2024 (Department of Health letter).
Minnesota
Who: Uninsured patients with household income under $125,000.
Limit: No more than the lowest amount a private insurer would pay for the same service, including the insured patient's share.
Law: Minn. Stat. §144.589.
Connecticut
Who: Uninsured patients with income up to 250% who have been denied Medicaid.
Limit: No more than the cost of care (charges times the hospital's cost-to-charge ratio), for the hospital and clinicians billing through it.
Law: C.G.S. §19a-673.
Ohio
Who: Ohio residents not on Medicaid with income at or below 100% of the poverty level.
Limit: Basic, medically necessary hospital services free at hospitals in the program, which most Ohio hospitals join (physician bills not included).
Law: Hospital Care Assurance Program (HCAP), Ohio Adm. Code 5160-2-17.
Washington
Who: Any patient, insured or not, for the part they owe; family income up to 400%.
Limit: Free up to 300% at hospitals in large health systems (200% at others), then 75% and 50% discounts.
Law: RCW 70.170.060.
Oregon
Who: Patients of nonprofit hospitals, household income up to 400%.
Limit: Free up to 200%, then at least 75%, 50% or 25% off.
Law: ORS 442.614.
Maryland: one price for everyone, free care up to 200%
Maryland works differently: a state commission (HSCRC) sets each hospital's rates for all payers, so the cash price and the insurers' price are close, and much lower than in most states for scans and tests. Separately, Maryland law (Health-General §19-214.1) requires free medically necessary care for family income at or below 200% of the federal poverty level, 75% off up to 250% and 60% off up to 300%, and discounts up to 500% when medical debt exceeds 25% of family income in a year. Immigration status does not count.
Everywhere else: the federal rule for nonprofit hospitals
In every state, a nonprofit hospital must have a written Financial Assistance Policy under section 501(r) of the federal tax code and may not charge patients who qualify more than the amounts generally billed to insured patients for emergency and other medically necessary care. You can apply up to 240 days after the first bill. IRS, section 501(r). Letters you can copy.
How to use a state limit
- Before a planned visit, ask the billing office for its financial assistance or discount policy and the application, and say which state law you are asking about.
- Have proof of household income ready (tax return, pay stubs); hospitals may also screen you for Medicaid first.
- Compare the limit with the hospital's published cash price on its page here: in New Jersey and California the legal limit is often lower.
- Bills from the radiologist, surgeon or anesthesiologist are separate; some of these laws cover them (Colorado's covers clinicians working in the hospital), others do not.
Questions
Does New Jersey law limit what a hospital can charge me without insurance?
Yes, if you are an uninsured New Jersey resident and your family income is below 500% of the federal poverty level: a hospital may not charge you more than 115% of what Medicare pays for the same service (P.L.2008, c.60).
Can a California hospital charge an uninsured patient more than Medicare?
Not if your family income is at or below 400% of the federal poverty level: the hospital must limit its expected payment to what it would expect from Medicare or Medi-Cal, whichever is greater (Health and Safety Code §127405).
Do New York hospitals have to give free care to uninsured patients?
Yes, below 200% of the federal poverty level: since October 20, 2024, New York hospitals must waive all charges for eligible uninsured patients, and charge those up to 400% no more than 10% or 20% of what Medicaid would pay (Public Health Law §2807-k(9-a)). Immigration status does not count.
My state is not listed. Do I have any protection?
If the hospital is nonprofit, the federal 501(r) rules apply in every state: a written Financial Assistance Policy, a free application, and no more than the amounts generally billed to insured patients for those who qualify. Many states have other charity care rules too; ask the hospital for its policy.
This page summarizes state laws in plain words; it is not legal advice. Check the linked text and ask the hospital which rules it applies.