California hospital bills: the free-care rules.

The law: Hospital Fair Pricing Act — Cal. Health & Safety Code §§127400–127446

The five cells for California

• Free care: California law does not set the free-care percentage itself. It forces every hospital to run BOTH a charity care (free) policy and a discount payment policy for patients up to 400% of the poverty guidelines — the split between free and discounted is written in your hospital's own policy (many hospitals set free care at 200%). Two hard rules protect you: the hospital may NOT consider your assets (§127405(b)), and discounted prices are capped at what Medicare or Medi-Cal would pay, whichever is more. (Cal. Health & Saf. Code §127405)
• Discounts: Discounted payment must be offered up to 400% of the poverty guidelines, with the price capped at the greater of Medicare or Medi-Cal expected payment — not the sticker price. (Cal. Health & Saf. Code §127405(d))
• Must the hospital screen you? Yes — and it gets stronger soon. From July 1, 2027, California hospitals must screen patients and decide eligibility before billing when a patient is on a program like CalFresh, CalWORKs or WIC, or is experiencing homelessness (Health & Safety Code §127406). Hospitals already must screen you for Medi-Cal and discount payment when you ask.
• Your application window: No longer state application window found — the federal 240 days protects you. Separately, California bars a hospital from selling your debt for at least 180 days and requires screening certification before a collector can sue (AB 1020).
• Medical debt & credit reports: Yes — California law (SB 1061, effective January 1, 2025) keeps medical debt off credit reports.

Figures marked from statute, regulation, or agency text read directly in our research pass. Checked October 19, 2026.

California numbers for 2026

Guidelines: 2026 HHS Poverty Guidelines (Federal Register, January 2026). Lines shown use California's statutory percentages where the state sets them; "typical policy" marks the most common hospital-policy lines where it doesn't. Your hospital's policy is the deciding document — the kit shows you how to get it and read it.

The federal floor under all of it

At any nonprofit hospital in California: a written financial assistance policy must exist and be publicized; you have 240 days from the first post-discharge bill to apply; no extraordinary collection actions for 120 days or while a complete application is decided; charges for eligible patients are capped at amounts generally billed; and money paid above what you owed comes back when a submitted application is approved. The full plain-words version.

California questions