Wisconsin Hospital Unpaid Care Tops $2 Billion in 2025

More than 2 million patient visits at Wisconsin hospitals involved unpaid care in 2025, according to the Wisconsin Hospital Association’s annual report.

The association states that hospitals provided over $2 billion in uncompensated services last year. This figure represents approximately 2 percent of total patient charges and is 15 percent higher than the 2024 total.

The unpaid amount is split between two categories: charity care for patients unable to pay and bad debt, which consists of bills hospitals have been unable to collect. The increase was driven primarily by charity care, which jumped nearly 29 percent from the previous year. Bad debt increased by only 4 percent.

Kyle O’Brien, president and CEO of the Wisconsin Hospital Association, noted that many patients face competing financial pressures. “As people have pressures in other parts of their life for expenses, whether it be housing or food or gas or whatever else, it may be more difficult for them to pay for other bills,” O’Brien said.

O’Brien also pointed to insurance denials as a factor. When private insurers, including Medicare Advantage plans, reject claims for services already performed, the cost often shifts to the hospital if the patient qualifies for charity care. This dynamic affects hospital operating margins and their ability to invest in staff and services.

Benjamin Vatter, an assistant professor at the Massachusetts Institute of Technology who studies healthcare markets, said the data suggests the burden falls on specific demographics. “It tends to be younger people, a lot of working-age people,” Vatter said. In states that did not expand Medicaid, these costs often impact individuals falling into the gap between Medicaid eligibility and exchange subsidies.

Vatter added that underinsured patients, whose plans leave them responsible for large portions of care, also contribute to the unpaid totals. He observed that if patients do not know how to negotiate discounts, they may simply stop paying. However, he noted that hospitals do not bear the full cost alone, as federal programs reimburse some of this care and tax exemptions for nonprofits support charity care operations.

Hospital leaders expect the trend to continue. The report projects that total bad debt for 2026 will be 18 percent higher than in 2025. Charity care is projected to rise by 3.5 percent from the 2025 level.

Bobby Peterson, executive director of the public interest law firm ABC for Health, stated that Wisconsin’s next governor will need to address the growing issue. He suggested that helping individuals find existing coverage and assistance could reduce medical debt. “A proactive approach can really take out a lot of this so-called medical debt,” Peterson said.

Marketplace enrollment in Wisconsin declined by 7 percent for 2026, according to data from the Wisconsin Office of the Commissioner of Insurance. The agency attributed the drop to market destabilization driven by federal actions. Congress allowed premium tax credit increases from the pandemic to expire at the end of 2025. Additionally, administrative changes to Medicaid, including a new work requirement, could lead to coverage expiring for tens of thousands of residents. The current open enrollment for the Health Insurance Marketplace ends on December 15.

O’Brien urged patients to contact local hospitals for coverage assistance and to monitor enrollment periods. He expressed concern that administrative hurdles may make it harder for eligible people to maintain insurance.