Senate committee reviews SB13 to set statewide charity-care minimums for hospitals

Chair Pinckney introduced SB13 as a measure to set minimum standards for hospital financial assistance and strengthen consumer protections against medical debt. "One of the most important parts of this legislation is that it prevents aggressive collection activity while a patient's financial assistance application is pending," Pinckney said.

Secretary Kristen Link Young, introduced by the chair, told the committee SB13 would make Delaware a national leader in charity-care protections and framed the bill as complementary to state investments in primary care and safety-net providers. "This bill today is a critical step to take patients out of the middle and ensure that their interests are protected," Young said.

Under the bill, patients at or below 300% of the federal poverty line would qualify for full assistance; thresholds scale up to partial reductions at higher income tiers. The bill requires hospitals to maintain a medical-hardship policy, proactively notify patients (including multilingual notices and oral notification), screen for uninsured or underinsured status, and report application and approval data to the Diamond State Hospital Cost Review Board.

Committee members asked how eligibility would be calculated and whether hospitals or insurers would absorb costs. Secretary Young and DHA representatives said eligibility calculations would be income-based (not asset-tested) and that hospitals already write off significant uncompensated care; DHA and the Medical Society flagged operational concerns. Carling Ryan of the Delaware Health Care Association cautioned the bill could incentivize carriers to design plans with higher deductibles and coinsurance, which could shift costs into patient-responsibility categories eligible for charity care.

Dr. Cedric Barnes, representing the Medical Society of Delaware, opposed SB13 as written, citing administrative burden on hospital-contracted physician practices and workforce constraints. Brian Frazee of the Delaware Healthcare Association and Alex Casper of the American Lung Association testified in support while noting the need for operational amendments and continued collaboration.

The sponsor and the department agreed to continue stakeholder work and study insurer responses in the coming year before the committee advances final language.