Robbing Hood: Unmasking Nonprofit Hospitals

Meet Robbing Hood. Evolving from his origins as an aide to those in need to the exact opposite – someone who takes from the poor and gives to the rich – Robbing Hood embodies the progression of America’s nonprofit hospitals. 

Over the years, hospitals have changed from charitable, essential pillars of the communities in which they operate to big businesses whose interests are at odds with the health and financial security of our nation’s families.  

Hospitals across the country – including many nonprofit hospitals that receive millions in tax breaks for the promise of providing charity care and community benefits – are systematically saddling low-income patients who should qualify for free or reduced care with devastating bills. These hospitals are also deploying predatory bill collection practices to hound vulnerable patients who are unable to pay. 

Despite a federal rule requiring hospitals to post all prices online in an easily accessible and searchable format, only 34.5 percent of hospitals were fully compliant as of February 2024. At the same time, Lown Institute’s 2024 Fair Share Spending Report found that 80 percent of nearly 2,500 nonprofit hospitals evaluated spent less on financial assistance and community investment than what they are estimated to receive in tax breaks. Furthermore, hospitals are consolidating quickly, creating medical monopolies and leaving communities with few options for care, and leaving patients in the dark on what they will be expected to pay for services. Given this environment, it’s no surprise that 100 million people in America are carrying health care debt.