Free care is funded by a surcharge on hospital bills that are paid by private insurers.
Hospitals also engage in internal cost shifting to cover the costs of free care patients. However, as managed care reduces cross-subsidies, the source of free care funds is drying up. Because no federal law guarantees free care, each state creates its own policy, which can vary from one community to another. Although free care is an important resource for the uninsured, many do not know it is available or how to access it. In addition, free care is often limited to certain services, and some doctors are hesitant to treat free care patients because free care usually only reimburses the hospital s fees, not the doctor s.