‘Chaos to the system’: Senate moves nonprofit hospital bill forward, despite impassioned debate

Republican lawmakers passionately debated legislation to tackle health care costs among Indiana’s largest nonprofit hospitals. The Senate ultimately voted to move the measure forward and return it to the House with amendments.

Several lawmakers flagged concerns about the consequences of HB 1004 for rural health care systems and charity care. The measure also freezes the prices for Indiana’s five largest nonprofit hospital systems — failure to do so would result in them losing their nonprofit status.

That’s a sticking point for several senators who spoke on the measure, including Sen. Jim Buck (R-Kokomo).

“What happens to a nonprofit that loses that status? I have no idea,” Buck said. “And that scares the bejeezus out of me.”

Indiana’s largest nonprofit hospital systems would not be allowed to exceed the prices set before Jan. 1, 2025. The five systems are: Indiana University Health, Parkview Health, Franciscan Health, Community Health Network and Ascension Health.

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Sen. Tyler Johnson (R-Leo) said the caps may push those health care systems to preemptively move to for-profit models.

“All we’re gonna do is provide chaos to the system — and we still don’t understand what this bill does with caps in it,” Johnson said.

But Sen. Chris Garten (R-Charlestown), the measure’s Senate sponsor, said the bill demands accountability from the health care system for Hoosiers.

“If you can’t be competitive with your pricing as a nonprofit, with the systems that are for-profit, then why should you enjoy the privileges of being a nonprofit in Indiana?”

Garten said legislation like HB 1004 is necessary because “hospital prices and the rate at which they’ve grown” have outpaced all other consumer goods.

The House can either choose to adopt the Senate’s changes — including the price caps — or take the measure to a conference committee to settle on a final version of the bill.

Lauren is our digital editor. Contact her at [email protected] or follow her on Bluesky at @laurenechapman.bsky.social.