OLYMPIA, WA — Legislation introduced in the Washington Legislature would limit hospital charity care eligibility to state residents, a move supporters say is intended to protect access to care and reduce strain on hospital capacity.

House Bill 2250, sponsored by Rep. Andrew Engell of Colville and several bipartisan co-sponsors, would restore residency requirements for non-emergency charity care while continuing to require hospitals to provide charity care for emergency services regardless of residency. The proposal follows a 2022–2023 interpretation by the Washington State Department of Health that directed hospitals to remove long-standing geographic restrictions from their charity care policies .

According to the bill’s findings, Washington hospitals provided approximately $483 million in charity care in 2022. Lawmakers backing the measure argue that eliminating residency limits for non-emergency care could encourage patients from outside the state to seek free treatment in Washington, potentially increasing wait times and costs for residents. The legislation states that Washington already has among the fewest hospital beds per capita nationwide and that additional demand could further strain capacity .

Engell said the policy change has had noticeable effects on some facilities near state borders. “It resulted in about a tripling of out-of-state residents coming to Newport, Washington to get hospital care and expecting it to be free,” Engell said in a radio interview discussing the bill .

Under the proposal, a Washington resident would be defined as someone currently living in the state with intent to remain, including people without a fixed address or those who entered the state for work. The bill specifies that individuals who come to Washington specifically to obtain health care would not qualify for charity care, except in emergency situations. Immigration status would not be considered when determining residency eligibility .

Engell said emergency care protections would remain unchanged. “If you’re traveling in Washington state and you have a heart attack and you’re under the poverty threshold, the hospital would still have to give you charity care,” he said. “But you may not come to Washington for a non-emergent procedure and expect it to be done for free on the backs of the people of Washington” .

House Bill 2250 has been referred to the House Health Care and Wellness Committee, where it is awaiting a public hearing.