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SB 6257

Defining Washington state residency requirements for purposes of hospital charity care.

2023-2024 Regular Session Introduced by Annette Cleveland and 3 co-sponsors

Defines residency for hospital charity care as Washington residents only, with limited nonresident emergency access; effective immediately via emergency clause.

First reading, referred to Health & Long Term Care.
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Bill Summary · SB 6257

Summary of SB 6257 (Defining Washington state residency requirements for purposes of hospital charity care)

Overview

SB 6257, introduced Jan. 17, 2024, and currently in the first reading in the Health & Long Term Care committee, would add a new section to RCW 70.170 to define residency for hospital charity care. The bill seeks to limit charity care eligibility to Washington state residents, reversing recent interpretive changes by the Department of Health that allowed nonresidents (including out-of-state or international patients) to access charity care. It includes an emergency clause taking effect immediately upon enactment.

Purpose and intent

  • The bill responds to concerns that removing geographic restrictions could turn Washington into a medical tourism destination, potentially delaying care for residents and increasing the overall cost of care for Washingtonians.
  • It emphasizes a standardized approach to charity care aimed at affordable medical care for low-income Washington residents, with limited emergency-related access for nonresidents only under specific conditions.
  • The bill notes the financial and capacity pressures on Washington hospitals and the potential impact on local residents’ access to care.

Key provisions

  • Sec. 2: New residency definition for charity care

    • Eligibility for charity care is limited to Washington state residents.
    • A resident is someone who currently lives in WA and:
    • intends to reside indefinitely (including those without a fixed address), or
    • entered WA seeking a job, or
    • entered WA with a job commitment.
    • No required minimum period of residency before eligibility.
    • Special rules for minors and guardians:
    • A child under 18 is a resident if the child lives in WA (with or without a fixed address) or if the child’s parent/guardian is a resident as defined above.
    • Residency maintained despite temporary absence:
    • If a resident leaves WA for over a month, they do not lose residency if they intend to return and are not eligible for Medicaid or state health coverage elsewhere (except for incidental/emergency care).
    • Non-residents for health care: a person who enters WA for health care is not a resident and not eligible for charity care.
    • Emergency care under 42 U.S.C. Sec. 1395dd (and guarantor) is considered residency for charity care purposes.
    • State supplemental payments and foster/adoption assistance:
    • Receipt of state supplemental payments or foster/adoption payments can establish or reflect residency as defined in the statute.
    • Immigration status cannot be used to determine indigence or residency.

  • Sec. 1 (findings): Contextual language describing charity care history, Department of Health policy changes in 2022–2023, and concerns about capacity, costs, and potential impacts on Washingtonians.

  • Sec. 3: Immediate effective date due to the emergency clause.

Affected parties

  • Washington residents, including those with unstable housing or varying residency status, who would be eligible for charity care under new residency rules.
  • Hospitals and health care providers in Washington (administrative/policy alignment with RCW 70.170).
  • Nonresidents seeking or receiving charity care for emergency or other services (limited under the bill).
  • Emergency patients and guarantors who rely on federal emergency care provisions.

Timeline and procedural notes

  • Status: First reading on January 17, 2024; referred to Health & Long Term Care.
  • Effective date: Immediate upon enactment due to the emergency clause.

Potential impacts (high-level)

  • Likely reduction in charity care access for nonresidents, with enhanced clarity for hospitals on eligibility.
  • Possible effects on hospital capacity management and demand, particularly in border or high-traffic areas.
  • Financial implications for hospitals and insured patients if charity care costs shift due to restricted eligibility.

Compiled from official sources — confirm details with the bill’s official record.

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