GOP Presidential Debate Participants’ Home States + Delaware Receive a #HospitalFail Grade from Consumers for Quality Care

By Consumers for Quality Care, on September 25, 2023

GOP Presidential Debate Participants’ Home States + Delaware Receive a #HospitalFail Grade from Consumers for Quality Care

For Immediate Release
September 25, 2023


GOP Presidential Debate Participants’ Home States + Delaware Receive a #HospitalFail Grade from Consumers for Quality Care


Nonprofit hospitals across the country are failing to meet hospital price transparency requirements while saddling patients with unnecessary and unmanageable debilitating debt


WASHINGTON, D.C. – Today, Consumers for Quality Care (CQC) published its latest set of Nonprofit Hospital Scorecards, spotlighting troubling hospital practices in states that are home to the leading GOP presidential candidates, as well as President Joe Biden’s home state of Delaware. Nonprofit hospitals in these states – including Delaware, Florida, Indiana, Ohio, New Jersey, New York, and South Carolina – have, despite their tax-exempt charitable status, been employing aggressive debt collection strategies against patients, failing to comply with hospital price transparency requirements, and falling short in providing charitable care to the vulnerable communities they are meant to serve.

These practices are especially troubling because nonprofit hospitals are tax-exempt, charitable organizations. They are expected to serve as accessible health care providers for low-income and vulnerable patients in their communities, extending free or low-cost care to eligible patients. Yet reports from highly-respected sources – including The New York TimesKFF Health NewsPatient Rights Advocate, the Lown InstituteFamilies USALeapfrog and others – have revealed that many nonprofit hospitals are failing to uphold what the public rightly expects of tax-exempt, charitable organizations.

The latest round of scorecards paints a disquieting picture of nonprofit hospitals in these seven states:

  • Indiana ranks tenth in the nation for the highest hospital prices.
  • New Jersey nonprofit hospitals have pocketed tax breaks that are $117 million more than they spent on charity care.
  • New York hospitals rank 40th in the country for patient safety, with more facilities earning ‘D’ grades for safety (24) than those earning ‘A’ grades.
  • Delaware ranks 49th in the country for hospital safety, with no hospitals reviewed in the state earning an ‘A’ grade for patient safety.
  • The Lown Institute Hospitals Index found that, based on tax filings from the fiscal year ending in 2020, hospitals in Florida had a “fair share deficit” of $412 million dollars, meaning nonprofit hospitals in Florida pocketed tax breaks that were $412 million more than what they spent on community benefits and charity care for low-income patients.
  • Twenty of 28 Ohio hospitals investigated by KHN from November 2021 to December 2022 have policies allowing them to sue their patients or take other legal actions to collect unpaid medical bills. More than 20% of the hospitals investigated will deny non-emergency care to patients with outstanding bills.
  • According to a 2022 analysis, 22% of South Carolinians have medical debt in collections, more than the national average of 13%.

“Nonprofit hospitals are granted tax-exempt status with the expectation that they will offer health care to patients without saddling them with medical debt,” said CQC Board Member Jim Manley. “Unfortunately, many are failing to uphold their obligations as charitable entities, prioritizing profits over the welfare of the patients they are meant to serve. Even the nonprofit hospitals in the home states of our President and those running for election to the highest office in our nation are too often falling short. They must be held accountable. Americans deserve protection from the predatory practices employed by the institutions they rely on in times of need.”

Legislation like the No Suprises Act and the Centers for Medicare & Medicaid Services’ (CMS) Hospital Price Transparency Rule are important steps in the right direction, but CQC calls on our leaders to do more to protect consumers. CQC urges the President and all presidential candidates to prioritize safeguards for patients, including the establishment of clearer eligibility standards for charity care, stronger requirements for nonprofit hospitals to deliver this care, and protections against aggressive debt collection practices.

“Nonprofit hospitals were created to give patients access to quality health care, but instead are falling short on charity care while increasing their bottom line,” Manley continued. “American health care consumers should not live in fear of overwhelming medical debt every time they need medical attention.”

Through its #HospitalFail Campaign, CQC is spotlighting the issue of nonprofit hospitals prioritizing financial gains over affordable patient care. CQC calls on our leaders in Congress and in the executive branch to take decisive action to safeguard health care access for American consumers.

View all of CQC’s Nonprofit Hospital Scorecards here. CQC will continue the Nonprofit #HospitalFail Campaign in additional states throughout the coming months. To stay informed, visit our website here.



Consumers for Quality Care (CQC) a coalition of advocates and former policymakers working to provide a voice for patients in the health care debate as they demand better care. CQC is led by a board of directors that includes the Honorable Donna Christensen, physician and former Member of Congress; Jim Manley, former senior advisor to Senators Edward Kennedy and Harry Reid; Jason Resendez, community advocate and health care strategist; and Mary L. Smith, former head of Indian Health Service.