Since 2019, UVA’s spending on charity care has risen more than 40 percent, to $110 million. Eze Amos
Dan, 48, moved from the Midwest to Charlottesville to get treatment for a rare, often painful genetic ailment at the University of Virginia hospital. “I’m in the process of getting disability,” he says, speaking anonymously. “I have limited capacity for work. I’m still working, but it’s very part-time.”
In his efforts to obtain life-changing care, he’s getting help from a surprising source.
“UVA is covering all of my medical bills,” he says, “because right now I don’t have insurance. In medication alone, that’s more than $1,000 a month.” Dan was one of the nearly 20,000 patients in fiscal 2026 who paid less—or nothing at all—for care through UVA’s charity and indigent care programs.
In 2019, UVA Health drew nationwide scorn when reporting from The Washington Post and the Kaiser Family Foundation revealed its rapacious, life-wrecking pursuit of unpaid hospital bills. Chastened by the bad press, the hospital system dropped many of its collection efforts, instead helping more patients cover the cost of care. Seven years later, UVA’s ongoing support of charity care could prove more crucial than ever, as cuts to social safety nets threaten to increase health care burdens for individuals and hospitals alike.
“As a state institution and a safety-net hospital, UVA Health is here to serve all patients, regardless of ability to pay,” says Eric Swensen, UVA Health’s public information officer.
UVA joins many other Virginia hospitals in providing charitable care. In 2024, the Virginia Hospital & Healthcare Association reported that hospitals spent $457 million statewide helping patients who otherwise couldn’t afford care.
In FY26, Swensen says UVA picked up the tab for 19,487 patients. Bills for those enrolled in the hospital system’s indigent care program are reimbursed via state funding. But the university pays for the rest, who occupy what UVA refers to as its charity care program, out of its revenues from insurers and other paying patients.
In FY19, UVA provided $253 million worth of indigent and charity care. By FY26, that figure had risen to $455 million. The health system’s costs grew more than 40 percent in the same period, from $77 million to $110 million.
“Since 2019, we have not filed any lawsuits against patients for not making payments for their care,” Swensen says. Where it once dragged tenants through court and dredged their savings to collect, UVA Health now offers a stronger financial assistance program that covers more people, and is easier to find and enroll in.
According to the hospital system’s guidelines, uninsured patients with $50,000 or less in assets and income below a given threshold—$31,920 a year for individuals, or $66,000 for a family of four—are eligible for a 100 percent discount on their care. Even individuals making up to $63,840, or families of four with incomes as high as $132,000, are eligible for at least a partial discount. The hospital system has embraced a host of measures to match patients in need with programs that can cover their care, help those patients avoid surprise bills, and pay down what they owe affordably, without interest or harm to their credit scores.
That extra help couldn’t come at a better time. In July, Virginia saw more than 67,400 fewer people enroll in health insurance plans through its state-run Affordable Care Act exchange compared to the previous year. In April, the director of the state’s health care exchange called the 33,000 Virginians who ditched their coverage from January through March the biggest first-quarter drop he’d ever seen. And he predicted more people would drop coverage after Republicans in Congress, including 5th District Rep. John McGuire, refused to continue providing tax credits that made those plans more affordable. A July press release from the exchange estimated that 100,000 fewer Virginians would be covered under ACA plans by the end of the year.
Meanwhile, the Virginia Hospital & Healthcare Association reported last month that emergency room visits by uninsured patients rose 8 percent in 2025. And it predicts $31 billion in funding cuts to hospitals over the next decade, after the Centers for Medicare & Medicaid Services unveiled a new rule that reduces Medicaid payments even more sharply than the bill that McGuire and other Republicans passed in 2025.
UVA says it can’t foresee how those changes will affect its patients or its own funding. “It is likely that more patients will seek financial assistance beginning in January,” Swensen says. “Our finance team closely monitors these changes and factors these types of changes into UVA Health’s budget planning so that we can continue to serve all patients.”
“One of UVA Health’s goals is that no Virginian—whatever their financial status may be—should have to leave the Commonwealth to receive the care they need,” he says.
Charity care from UVA is “a massive relief for me, because I don’t have the money,” Dan says. “I’m almost two years into the process of applying for disability. … Just knowing that health care that I absolutely need isn’t going to be a barrier economically is a huge relief.”
