Ohio

Process / partial

HCAP requires participating hospitals to provide basic, medically necessary services without charge to uninsured Ohio residents at or below 100% FPL. That is a low floor. Above it, use the hospital FAP and 501(r). Medicaid is expanded.

Ohio Rev. Code § 5168.14 (Hospital Care Assurance Program) · compiled September 2026

Rule	This state
Free-care floor	100% FPL
Discount / eligibility floor	100% FPL
Covers insured patients	Uninsured-focused statute
Which hospitals	Generally all licensed hospitals
Medicaid expansion	Yes — adults to 138% FPL
Screen before collections	Yes
Credit reports	No state ban
Debt sales	Not banned
Home liens	Not banned
Wage garnishment	Federal CCPA cap (typically 25%)
Interest on medical debt	No special cap located
Collection hold	No extra state waiting period
Lawsuit clock	6 years · Ohio Rev. Code § 2305.06

2026 poverty line here

Alaska and Hawaii use their own HHS tables. Everyone else uses the 48-state and D.C. figures, effective January 2026.

Household	100%	Free floor	Discount floor
1	$15,960	$15,960	$15,960
2	$21,640	$21,640	$21,640
3	$27,320	$27,320	$27,320
4	$33,000	$33,000	$33,000
5	$38,680	$38,680	$38,680
6	$44,360	$44,360	$44,360

What to do

01 Uninsured at or under poverty: demand HCAP, not a payment plan.
02 Above 100% FPL, HCAP ends. The hospital FAP (often 200–400%) is the real write-off.
03 Apply for Medicaid — Ohio expanded.
04 Six-year lawsuit window.

Appeals

Federal No Surprises Act.

Insurance: Ohio Department of Insurance — external review

Medicaid: ODM fair hearing.

Medicare is federal regardless of state: redetermination, reconsideration, ALJ, Appeals Council, then district court.

Cite this in a letter

If I am an uninsured Ohio resident at or below 100% of FPL, I request Hospital Care Assurance Program coverage under Ohio Rev. Code § 5168.14. I also request a full FAP review under Internal Revenue Code section 501(r).

Put a Ohio bill in the machine.

The estimate will use this state’s floors. The letters will cite Ohio Rev. Code § 5168.14 (Hospital Care Assurance Program).

Start a Ohio case

Ohio Attorney General

Federal overlay — every state

501(r)
501(c)(3) hospital organizations must publish a Financial Assistance Policy, a plain-language summary, and generally may not take extraordinary collection actions (selling the debt, reporting it, liens, lawsuits) until they have made reasonable efforts to determine FAP eligibility.
No Surprises Act
Emergency services, air ambulance, and many out-of-network clinicians at in-network facilities cannot balance-bill beyond in-network cost-sharing. Independent dispute resolution is between the plan and the provider — not a reason to pay the sticker rate.
FDCPA
15 U.S.C. § 1692g. Within 30 days of first collector contact, demand validation. Until validated, collection and credit reporting should stop. Partial payment can restart a state’s statute of limitations.
EMTALA
Emergency departments must screen and stabilize regardless of ability to pay. An ER bill is not an agreement that chargemaster rates are the cash price.
Medicare appeals
Five levels: redetermination (MAC, 120 days), reconsideration (QIC), ALJ at OMHA, Medicare Appeals Council, then federal district court. A remaining patient balance is often a claim the provider still needs to work.
Credit bureaus
The CFPB’s 2025 medical-debt reporting rule was vacated in July 2025. Industry practice still generally omits paid medical collections and unpaid balances under $500. Unpaid medical debt over $500 can appear after a delay unless a state ban applies. FCRA-preemption fights over those state bans are ongoing.