Stare Decisis Precludes Innovative Risk Transfer Strategy

Most residents in South Texas qualify for free hospital care under Hospital Financial Assistance Programs (HFAP) promulgated under the Affordable Care Act.

HFAP qualifications differ from hospital to hospital but the average starting point is between 200-400% of the Federal Poverty Level (FPL).

According to the state comptroller’s office, in 2018, the The South Texas Region’s median household income was $42,246. This means most residents qualify for HFAP assistance.

Statewide statistics include:

  • Of more than 9 million Texas households, 21 percent had incomes less than $25,000 in 2018, while 17 percent had incomes greater than $125,000.
  • In every region in the state, nearly 18 percent of households had average incomes between $50,000 and $75,000.
  • Nearly 58 percent of the region’s households had incomes below $50,000 and 33 percent had incomes below $25,000 About 9.3 percent of South Texas households had incomes above $125,000.

Let’s pick one hospital to examine how a Financial Assistance Policy may benefit community members. Lets help this hospital to fulfill their charitable mission.

Valley Baptist hospital located in Harlingen offers financial assistance to those whose household income is less than 350% of the federal poverty level or whose total medical expenses exceeds 10% of their household income.

XXXXXXXXXXXXXXXXXXXXXXXXXXXXX

Valley Baptist Financial Assistance Policy

If you don’t qualify for government programs, but don’t have the means to pay for your hospital expenses, you may be able to receive charity care. You may qualify for hospital financial assistance if your household income is below 350 percent of the federal poverty limit or if your annual out of pocket medical costs exceeded 10 percent of your household income in the past 12 months.

To be considered for this assistance program, you’ll be required to provide information on your household finances through a confidential financial application. Documentation will be requested to verify your circumstances in order to determine eligibility. Please call us at (956) 389-1685, Monday through Friday, 6 a.m. to 6 p.m. CST for additional information.

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

350% of the federal poverty level for a family of one is about $47,000. A family of four whose family income is 350% of the FPL is about $97,000.

A school teacher with spouse and children with a household income of less than $100,000 will likely qualify for HFAP assistance. Minimum wage earners in every industry will probably qualify too.

Why should employers provide health insurance for plan members who qualify for free care under the Affordable Care Act? Why don’t plan sponsors employ HFAP’s as a significant risk transfer strategy? How Many of Your Employees Are Eligible For Free Hospital Care? .  Many of them may qualify for free hospital care.

Justice Clarence Thomas has the answer: “We use star decisis as a mantra when we don’t want to think.”

RELATED BLOG POSTINGS:

In IRS First, Non-Profit Hospital Loses Status Under ACA Rules

Hospital Fair Share Spending