An Eastern Washington hospital is overwhelmed with patients seeking the progressive state’s ‘charity care’ policy. They’re from across the border in Idaho
A rural hospital along the Idaho border has been feeling the pinch from an influx of people coming from outside Washington who, under state law, can receive free health care there.
“Our margins are already very, very thin,” said Newport Hospital interim CEO Justin Peters. “Charity care for our community is one thing, but having people come from other states and providing that charity care really puts a strain on our hospital.”
Newport Hospital is a stone’s throw from Idaho and over an hour’s car ride away from the nearest major city . It’s been hit hard by that out-of-state charity care.
The hospital experienced a 43% jump in charity care money spent from 2024 to 2025, Peters said. Nearly half of the charity care provided by the hospital goes to people out of state.
Besides emergency care, Newport Hospital also provides orthopedic surgery, behavioral health care and gynecological services, among other things.
“We fully expect to provide charity care for especially emergency,” said hospital spokesperson Jenny Smith. “But when you’re looking at it for other services, it really gets tricky.”
A proposed bill in the Washington Legislature, introduced by Rep. Andrew Engell, R-Colville, would have limited nonemergency charity care to residents of the state. Engell said the bill was not pushed through due to some of the language and wording.
“It’s really about, how much can Washington and our hospitals be expected to bear at no cost?” Engell said.
He said he had meetings with people who spoke in opposition of his bill during the hearing last month.
“I think we can work it out,” he said. “I feel pretty optimistic we could probably get this through next year.”
Charity care offers free or discounted medical care to people without insurance who meet certain income thresholds. With the passage of Washington’s charity care law in 1989, hospitals were allowed to draw their own geographical limits for their charity care.
That changed when, in 2023, the state Department of Health barred the geographical limits for hospitals in the state because of a law passed the year before. The Department of Health argued charity care eligibility can only be decided by income, not location.
In Washington, the threshold is 300% of the federal poverty level – a family of four would be eligible if they made less than $100,000 in a year.
The issue of charity care came across Engell’s desk after meeting with Newport Hospital last year. The bill garnered support from both sides of the aisle and from across the state.
“This is another example of what happens with national politics at our state level,” said Sen. Manka Dhingra, D-Redmond. “Over and over again, what we are finding is that the state has to spend more resources taking care of people that should have access to health care in their own state.”
Pullman Regional Hospital saw a 28% spike in total charity care from 2023 to 2024, according to figures from the Department of Health.
Noting “the financially challenging landscape of health care,” MultiCare, which owns Deaconess Hospital in Spokane, supported the proposed bill.
MultiCare spokesperson Kevin Maloney said in a statement the bill would “allow us to continue to focus our resources towards care for Washington State residents.”
MultiCare Deaconess spent nearly $2 million more in 2024 on charity care compared to 2023. Providence Sacred Heart Medical Center spent $18 million more in the same time frame.
Washington as a whole saw a 34% increase in charity care spent from 2023 to 2024. Around 65% of charity care applications submitted were approved by the hospitals in 2024.
“The real concern for me that I was trying to fix is about Newport hospital on the Idaho border,” Engell said.
Since the passage of President Donald Trump’s “One Big Beautiful Bill Act,” Peters fears that charity care cases will further be exacerbated should premiums go up and people lose access to insurance.
“That’s a huge worry of ours,” Peters said. “That’s going to cause patients to be uninsured or underinsured, which ultimately is going to be increased in our charity care.”
The One Big Beautiful Bill Act set up a fund to support rural health, from which the state is expecting $181 million, but Peters said the program will not be enough.
“It’s kind of a misconception that that’s going to help offset a lot of this charity care,” Peters said. “We don’t feel like it’s going to even touch the surface of what it truly is going to have the impact for.”
Editor’s note: This story was updated on Feb. 17, 2026, to reflect that state Sen. Manka Dhingra is from Redmond, not Seattle.
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