More uninsured and low-income Iowans are making trips to the hospital and getting free care. The Iowa Hospital Association reports "charity care" costs increased 22% over the first three quarters of 2008 compared to the same period in 2007. Spokesperson Scott McIntyre says it’s no secret that more Iowans are losing their health insurance.

"Folks are losing their jobs or their insurance or insurance is just becoming unreachable for them. That’s what we suspect is leading to the increase," McIntyre said. The problem in Iowa is growing, although Iowa still has fewer uninsured residents than most other states. Hospitals located in flooded parts of Iowa – or where more layoffs are occurring – are reporting higher percentages of charity care.

Des Moines’ largest hospital, Mercy Medical Center, reported only a steady increase in free care. "That didn’t surprise us, because Des Moines overall is doing pretty well compared to a lot of cities of similar size," McIntyre said. "But, in eastern Iowa and other parts of the state we’re seeing much, much higher (rates of) charity care."

While the trend is mainly blamed on the economy, many hospitals in Iowa have also eased their rules on who qualifies for free care. For the most part, the hospitals report charity-care figures based on full charges. The hospitals typically grant discounts of around 50-percent to insurance companies. The rise in charity care cases come at a time when more Iowans are also ending up on Medicaid, the government plan for the poor.

McIntyre says the situation may force a lot of hospitals to delay projects or find other ways to trim their budgets. "Last year, our hospitals lost about $177-million to Medicaid simply because Medicaid doesn’t pay for the full cost of care, so it’s a tough time for Iowa hospitals and they’re going to have to make some adjustments," McIntyre said. The Iowa Hospital Association includes all 117 hospitals in the state.