As ranks of uninsured grow, charity care can be hard to come by at many hospitals

An investigation of hospital data and charity care programs shows most Minnesota hospitals provide little financial aid to patients and often make assistance difficult to get.

Across Minnesota, the number of uninsured residents has climbed to an estimated 8.2% of the population, up from 5.7% in 2020. Yet the state’s hospitals, which collectively reported more than $1.2 billion in operating surpluses last year, have not proportionally increased their charity care offerings. A Tracker Bureau analysis of financial filings from 47 hospitals reveals that only 12% of eligible patients actually received any form of financial assistance.

The median hospital spent just 1.2% of its operating expenses on charity care in 2025, according to the filings. That figure is virtually unchanged from 2019, despite a 40% rise in the uninsured population over the same period. “Hospitals are making record profits while patients are drowning in debt,” said a senior researcher at the Minnesota Health Access Coalition. “The system is fundamentally broken.”

The application process itself often serves as a barrier. Of the 47 hospitals surveyed, 38 required applicants to submit tax returns, pay stubs, and a signed letter from their employer — documents that many low-income and uninsured individuals do not have readily available. Only five hospitals offered online applications, and none provided translation services for languages other than Spanish and Hmong.

Even when patients successfully apply, the amount of aid granted is often minuscule. The average charity care write-off per eligible patient was $312 in 2025, far below the typical cost of an emergency room visit ($1,200) or a three-day hospital stay ($8,500). “It’s a drop in the bucket,” said an industry analyst who studies hospital pricing. “These programs are designed more for public relations than actual relief.”

The Minnesota Hospital Association declined to comment on the findings, but in a 2024 report it noted that hospitals provided $1.8 billion in community benefits, including charity care, bad debt, and unreimbursed Medicaid costs. However, critics argue that “community benefits” is a broad category that includes marketing expenses and lobbying costs, inflating the true charity care figure.

The investigation also found that hospitals in wealthier suburbs were far more likely to advertise charity care programs than those in low-income urban neighborhoods. In Hennepin County, where the uninsured rate is 12.3%, only two out of seven hospitals had any visible signage or brochures about financial assistance in their emergency rooms.

State lawmakers have proposed legislation that would require hospitals to spend at least 5% of their operating revenue on charity care, a threshold that only three of the 47 hospitals currently meet. The bill faces opposition from the hospital lobby, which argues that mandatory spending could force rural hospitals to cut other services.