Community with high medical debt questions its hospitals' charity spending

PUEBLO, Colo. — As 41% of American adults face medical debt, residents of this southern Colorado city contend their local nonprofit hospitals aren't providing enough charity care to justify the millions in tax-breaks they receive.

The two hospitals in Pueblo, Parkview Medical Center and Centura St. Mary-Corwin, do not pay most federal or state taxes. In exchange for the tax break, they are required to spend money to improve the health of their communities, including providing free care to those who can't afford their medical bills. Although the hospitals report tens of millions in annual community benefit spending, the vast majority of that is not spent on the types of things advocates and researchers contend actually create community benefits, such as charity care.

And this month, four U.S. senators called on the Treasury's inspector general for tax administration and the Internal Revenue Service to evaluate nonprofit hospitals' compliance with tax-exempt requirements and provide information on oversight efforts.