A Washington State hospital is being overwhelmed because of a new “progressive” state policy that’s forcing its hand.
Washington has long had a state-mandated policy requiring that hospitals provide free or discounted care to low-income patients who can’t afford their hospital bills. It’s known as “charity care.”
When charity care became law in 1989, “hospitals were allowed to draw their own geographical limits for their charity care,” according to The Spokesman-Review. Hospitals wisely used this stipulation to limit their charity care to patients in their local vicinity and state.
But all this changed in 2023 when the state “barred the geographical limits for hospitals in the state,” meaning “charity care eligibility can only be decided by income, not location.”
A rural hospital along the Idaho border has been feeling the pinch from an influx of people coming from outside Washington who, under state law, can receive free health care there.https://t.co/FsGWoVYgfn
— The Spokesman-Review (@SpokesmanReview) February 17, 2026
Ever since this change, Newport Hospital, which lies on Washington’s border right next to rural Idaho, has been overwhelmed by low-income Idaho residents AND illegal aliens flooding their facility.
“Our margins are already very, very thin,” interim hospital CEO Justin Peters said. “Charity care for our community is one thing, but having people come from other states and providing that charity care really puts a strain on our hospital.”
The hospital has experienced a 43 percent jump in charity care cases, with half of those coming from out of state.
“Over and over again, what we are finding is that the state has to spend more resources taking care of people that should have access to health care in their own state,” state Sen. Manka Dhingra said.
In addition, charity care doesn’t just include emergency care — it also includes orthopedic surgery, behavioral health care, and gynecological services.
“We fully expect to provide charity care for especially emergency, but when you’re looking at it for other services, it really gets tricky,” hospital spokesperson Jenny Smith said.
The tiny bit of good news is that state Rep. Andrew Engell has proposed a bill, HB 2250, that’d limit non-emergency charity care to state residents.
“HB 2250, which has bipartisan support, defines residency broadly to ensure legitimate ties to Washington are recognized,” according to a press release from Engell’s office published last month.
“Eligible residents include people without a fixed address, individuals who recently moved to Washington for work or job-seeking, children living in the state, and others who call Washington home,” the press release continues.
However, the bill has thus far gone nowhere, allegedly due to concerns about “language and wording.”
“I feel pretty optimistic we could probably get this through next year,” Engell told the Spokesman-Review.
Plus, according to the press release from his office, “Immigration status may not be considered when determining eligibility” for charity care, meaning illegal aliens would still be able to benefit from it.
“This is about fairness and sustainability,” Engell said when the bill was announced. “Our hospitals are facing real capacity constraints and rising costs. Charity care resources should be focused on the communities they are intended to serve.”
Engell also warned of the unintended consequences that await if the law isn’t amended.
“We know that people respond to incentives. The current charity care structure creates incentives for non-Washington residents to travel to our state for expensive care, like a joint replacement, that they would otherwise have to pay for where they are residents,” he said.
“If it becomes well known that people under 300% of the federal poverty level can come to Washington for free nonemergency care, it would be devastating to the financial health of our health care system. Washington is not equipped to fund the health care needs of non-residents,” he added.
Newport Hospital isn’t alone in facing difficulties.
“Pullman Regional Hospital saw a 28% spike in total charity care from 2023 to 2024, according to figures from the Department of Health,” according to the Review. “MultiCare Deaconess spent nearly $2 million more in 2024 on charity care compared to 2023.”
“Providence Sacred Heart Medical Center spent $18 million more in the same time frame. Washington as a whole saw a 34% increase in charity care spent from 2023 to 2024. Around 65% of charity care applications submitted were approved by the hospitals in 2024,” the report continues.
Writers and editors can be contacted at [email protected] with feedback, tips, or corrections.
V. Saxena is a staff writer with a decade of experience as a professional writer, and a lifetime of experience as an avid news junkie. He holds a degree in computer technology from Purdue University. Saxena also contributes to BizPac Review.
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