New York Attorney General Letitia James yesterday released guidance explaining how residents can obtain discounts, free care, and payment plans for hospital bills under the state’s Hospital Financial Aid Law, and detailing restrictions on when those bills can be turned over to debt collectors.
The guidance arrives as federal funding changes reduce health coverage across the state. Under the budget law known as H.R. 1, New York’s Essential Plan income limit fell from 250% to 200% of the federal poverty level on July 1, 2026. The attorney general’s office estimated that roughly 450,000 New Yorkers lost zero-premium coverage as a result and shifted to marketplace plans carrying higher premiums, deductibles, and out-of-pocket costs.
The Hospital Financial Aid Law requires all hospitals in the state to offer financial assistance, sometimes called charity care, to patients who cannot afford their bills. Patients with household incomes up to 400% of the federal poverty level may qualify for discounts, and hospitals must waive all charges for patients earning less than 200%. According to the guidance, single residents earning less than $31,920 and four-person households earning less than $66,000 are entitled to free care, while single residents earning up to $63,840 and four-person households earning up to $132,000 may qualify for a discount.
Eligibility is not limited to the uninsured. Insured patients who have exhausted their benefits, or who have spent more than 10% of their household income on out-of-pocket medical costs over the past year, may also qualify.
The guidance outlines several constraints relevant to collections. Hospitals cannot send a patient’s bill to a debt collector while a financial aid application is under review, or for at least six months after sending the first bill. Hospitals also cannot deny emergency or medically necessary care over an unpaid bill, and cannot limit financial aid based on a patient’s medical condition.
Patients can apply using a standard application created by the New York State Department of Health and may do so at any point during the billing and collections process.
