Take cancer treatment, for example. It\u2019s notoriously expensive and can even send patients in stable financial situations, with comprehensive health insurance, into medical debt. Sometimes there are legal solutions, said Erin Hartung, director of legal services for Cancer Legal Care, a nonprofit providing assistance to Minnesota cancer patients with medical debt or other financial difficulties. But sometimes there aren\u2019t. So, her clients often look to options like one-time health care grants, food and travel assistance, or even GoFundMe.<\/p>\n
\u201cIt’s a lot to add on top of somebody’s medical treatments that they’re already trying to navigate,\u201d Hartung told MinnPost.<\/p>\n
Related: HCMC bailout offers life raft for a critical physician training program<\/strong><\/a><\/p>\n When outside options can\u2019t cover the costs, Hartung said some clients apply to the hospitals\u2019 financial assistance programs. For patients who qualify \u2013 some whose lives hang in the balance \u2013 the money can be lifesaving.<\/p>\n But for HCMC, financial assistance has become an almost impossible burden. The cost to the hospital of what is called \u201ccharity care\u201d not only has risen to unsustainable levels in recent years, but has far outpaced what other hospitals in the state have spent. And as the number of uninsured Minnesotans rises, the hospital finds itself in an increasingly untenable position with no simple solution in sight.\u00a0<\/p>\n HCMC\u2019s financial woes have been mounting for years, due in part to the shutdown of Minnesota-based health insurer UCare and changes to Medicaid eligibility brought on by the One Big Beautiful Bill Act. HCMC is set to face up to $50 million in operating losses this year alone, along with a staggering $1.7 billion in losses over the next decade, according to financial projections shared with the Hennepin County Board\u2019s budget committee in March<\/a>.<\/p>\n After weeks of intense discussions, Minnesota lawmakers passed an omnibus bill<\/a> securing $205 million for HCMC from the state\u2019s general fund in the final hours of the Legislative session<\/a>. Starting next summer, the hospital will also have access until 2031 to a $500 million reserve account, drawn from the state\u2019s rainy day fund.<\/p>\n \u201cThe stabilization funding does not resolve the long\u2011term impacts of HR1 or the structural deficits that uniquely challenge safety\u2011net hospital systems,\u201d Hennepin County spokesperson Joshua Yetman said in an email to MinnPost. \u201cBut it does accomplish two essential things: it delivers historic support that prevents closure, and it gives us the time and stability to work with the state on durable, long\u2011term solutions.\u201d<\/p>\n The cost to treat HCMC\u2019s uninsured or publicly insured patients, who make up roughly 75% of Hennepin Healthcare\u2019s patient base, according to a hospital fact sheet, are massive. Part of HCMC\u2019s mission as a safety-net hospital is treating all patients regardless of their insurance status or ability to pay, which has led to a large share of unpaid bills.<\/p>\n This phenomenon falls under a broader umbrella term called \u201cuncompensated care,\u201d said Scott Hulver, senior policy analyst with KFF, a health policy research, polling and news organization.<\/p>\n There are two major types of uncompensated care, Hulver explained: charity care and bad debt. Charity care, also called financial assistance, is when a hospital deducts a patient\u2019s medical bill because they were unable to pay but qualified for financial aid. Bad debt is when a patient does not pay their bill but does not qualify for charity care.<\/p>\n While virtually every hospital has some amount of uncompensated care costs, HCMC\u2019s costs represent roughly 20% of total costs statewide, Yetman said in an email.<\/p>\n In recent years, uncompensated care costs have skyrocketed at HCMC, where the threshold to qualify for financial assistance is lower compared to similar hospitals.\u00a0<\/p>\n Data from the Minnesota Department of Health (MDH)<\/a> shows that in 2014, the hospital had just under $24 million in uncompensated care costs. A decade later, that figure jumped to more than $90 million \u2013 an increase of almost 280%. Additionally, more than $88 million of HCMC\u2019s $90.3 million uncompensated care price tag in 2024 was for charity care, a 47.5% increase from 2023. The remainder \u2013 about $2 million \u2013 covered bad debt.<\/p>\n Regions Hospital in St. Paul, another Level 1 trauma center, had $55 million in uncompensated care costs in 2024, $25 million of which was charity care. Regions did not grant an interview to MinnPost, but Jimmy Bellamy, senior communications consultant with HealthPartners, said in an email that the hospital provides the \u201cmost charity care to underserved patients in the East Metro as a safety net hospital.\u201d Bellamy added that in recent years, Regions has seen a decline in patients on Medicaid and a rise in uninsured individuals.\u00a0<\/p>\n North Memorial in Robbinsdale, the other hospital in the metro area\u2019s trifecta of Level 1 trauma centers, only spent about $2.6 million on charity care that same year. North Memorial did not respond to MinnPost\u2019s repeated requests for comment.\u00a0<\/p>\n Yetman attributes the rise in uncompensated and charity care costs at HCMC to several factors, including an increase in uninsured or underinsured patients, post-pandemic hikes in clinic visits and more intensive inpatient stays, which increases the overall cost of delivered care \u2013 including treatment that goes unpaid.\u00a0<\/p>\n Beth Feldpush, senior vice president of advocacy and policy at America’s Essential Hospitals, representing safety-net hospitals across the country, including HCMC, said hospitals nationwide have experienced rises in patient volumes post-COVID due to individuals opting to delay treatment during the pandemic. Now, patients are coming in with more urgent needs and hospitals like HCMC are dealing with the backlog.<\/p>\n An additional 10 million people nationwide are projected to lose health insurance coverage due to federal changes to Medicaid, part of the One Big Beautiful Bill Act, Feldpush said, citing estimates from the Congressional Budget Office<\/a>. In coming years, she predicts more increases in charity care costs that will disproportionately affect HCMC and other safety-net hospitals.<\/p>\n \u201cWe’re going to see a lot more folks needing charity care, and at the same time that bill also cuts support for hospital funding,\u201d Feldpush said. \u201cHospitals are really looking at this double whammy, where they’re going to see more people needing charity care coming in through their doors, but also they’re going to have less ability and less financial support to provide that charity care.\u201d<\/p>\n HCMC also devotes more of its operating budget to charity care compared to other metro hospitals.<\/p>\n A KFF Health News and Minnesota Star Tribune investigation<\/a> published in May found that 80% of Minnesota hospitals spent less than 1% of operating expenses on charity care, with only 24 hospitals in the state spending more than 1%. HCMC is one of them, spending 3.62% of its operating budget, the highest percentage of any hospital in the state. Charity care accounts for just over 2% of Regions\u2019 operating budget and only 0.38% at North Memorial.<\/p>\n The reason may lie, in part, in HCMC\u2019s willingness to provide financial assistance. Compared to the other Level 1 trauma centers in the metro, HCMC is much less strict with its application requirements, meaning a wider range of patients qualify. Unlike some states, Minnesota does not have standardized eligibility criteria for who qualifies for charity care.<\/p>\n \u201cHospitals vary a lot in terms of what income thresholds they allow for financial assistance, whether the hospital provides some sort of discount to the care or whether they will cover 100% of a patient’s bills,\u201d Hulver said.<\/p>\n![\"Two](\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2026\/06\/full.png\")
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