Los Angeles County Hospital Bill Help 2026–27: The Ability to Pay (ATP) Program, Sliding-Scale Costs and How to Apply

23 hours ago

5 min read

A hospital stay or ER visit without insurance can leave a Los Angeles family with a bill they can't possibly pay. If you get care through Los Angeles County's public health system, called LA Health Services (the county Department of Health Services, or DHS), there's a financial assistance program built for exactly this situation.

The county states plainly that "No one will be denied access to services due to inability to pay." Its main program for county residents is the Ability to Pay (ATP) Program, which replaced the older ORSA program. ATP care is free for people with incomes at or below 200% of the federal poverty level (FPL), and above that, costs follow a capped sliding scale.

This guide explains who qualifies, what you'd pay, how to apply, and what to do if you're denied.

Last checked October 2026. Sources: LA Health Services' Patient Financial Services page; the ATP Program Cost Table effective April 1, 2026; the DHS "No-Cost or Low-Cost Medical Care" flyer (dated April 2022, used only for program rules that the current pages don't contradict); and a July 2026 county news release on the new uninsured program. This is general information; confirm with Patient Financial Services.

The Short Version

Who: Los Angeles County residents with medical costs that Medi-Cal, Medicare, private insurance or other benefits won't pay.
Free care: income at or under 200% FPL.
Above 200% FPL: a sliding scale with a fixed monthly cost for outpatient and ER care, and a fixed cost per hospital admission.
Where: County hospitals and clinics only, such as LA General, Harbor-UCLA, Olive View-UCLA, Rancho Los Amigos and county health centers.
How: apply during a financial screening appointment with Patient Financial Services, usually open Monday–Friday, 8 a.m. to 4 p.m.
Denied? File a complaint with California's Hospital Bill Complaint Program.

What ATP Costs in 2026

The county's ATP cost table, effective April 1, 2026, sets a single cost based on your household's income level. You don't pay per visit. You pay one amount per month for outpatient care, and one amount per inpatient admission.

Outpatient and emergency care (monthly cost):

At or under 200% FPL: $0
201–300% FPL: $20
301–350% FPL: $50
351–400% FPL: $80
401–500% FPL: $355
501–600% FPL: $435
Over 600% FPL: $485

Inpatient hospital care (cost per admission):

At or under 200% FPL: $0
201–300% FPL: $200
301–350% FPL: $700
351–400% FPL: $1,200
401–500% FPL: $2,500
501–600% FPL: $3,000
Over 600% FPL: $3,500

What 200% FPL means in dollars (monthly gross income, from the 2026 table):

1 person: $2,660
2 people: $3,608
3 people: $4,554
4 people: $5,500
5 people: $6,448
6 people: $7,394

The full table goes up to a household of 10. Count everyone, adults and children, who lives with you.

Example: A family of four earning $5,000 a month is under the $5,500 line, so ATP care would cost $0. If that family earned $7,000 a month (between 201% and 300% FPL), it would pay $20 a month for outpatient and ER care and $200 per hospital admission, no matter how many visits or how many days in the hospital.

Who Qualifies

To get ATP, the county's program materials say you must:

Live in Los Angeles County and prove it with an ID and proof of address. If you're homeless, a statement certifying homelessness is accepted.
Have medical costs that Medi-Cal, Medicare, private insurance or other benefits won't pay.
Apply for Medi-Cal if a county worker thinks you may qualify. If you don't fully cooperate with the Medi-Cal application, you can't get ATP.

ATP can also help people who have insurance:

It can be used for services not covered by Medi-Cal, Medicare or private insurance.
It can cover a private insurance deductible, but not Medicare deductibles or a Medi-Cal share of cost.

Immigration: The county's flyer states that it does not report patients to U.S. Citizenship and Immigration Services and that using these no-cost or low-cost programs won't make you a public charge.

How to Apply

Ask for Patient Financial Services (PFS) at any LA Health Services hospital or clinic, ideally before or right after your care.
Schedule a financial screening. You apply for ATP during this appointment.
Bring proof of identity, LA County address (or a homelessness statement), household size and income.
Apply for Medi-Cal at the same time if you might qualify. You can apply at BenefitsCal.com or by calling the DPSS Customer Service Center at (866) 613-3777.

The county's program flyer says an ATP approval is good for one year and covers both inpatient and outpatient care under one agreement.

Can't pay your ATP amount in 30 days? The flyer says patients in ATP can arrange to pay over a longer period through an extended payment plan, based on income, resources and family size.

Other County Payment Options

The county's flyer describes additional programs. Confirm current amounts with PFS, since the flyer dates from 2022:

Discount Payment Plan: for people who don't live in LA County, have no insurance or high medical costs, don't qualify for Medi-Cal and have income at or under 400% FPL. Only county residents can get no-cost care.
Pre-Payment Plan: a flat fee per visit for county residents. It covers clinic and ER visits and tests, but not inpatient stays or take-home medicine.
Child Delivery Plan: a flat fee covering labor and delivery for pregnant county residents.

County Hospitals Where ATP Applies

ATP covers care only at county hospitals and clinics, including:

Los Angeles General Medical Center (formerly LAC+USC), 2051 Marengo St., Los Angeles 90033
Harbor-UCLA Medical Center, 1000 W. Carson St., Torrance 90509
Olive View-UCLA Medical Center, 14445 Olive View Dr., Sylmar 91342
Rancho Los Amigos National Rehabilitation Center, 7601 E. Imperial Hwy., Downey 90242

County comprehensive health centers include H. Claude Hudson, Hubert H. Humphrey, Edward R. Roybal, El Monte, Long Beach, Mid-Valley, High Desert Regional and the Martin Luther King Jr. Outpatient Center. For a private or nonprofit hospital, ask that hospital for its own charity care or discount payment policy.

If You're Denied: The Hospital Bill Complaint Program

California runs a Hospital Bill Complaint Program, part of the state's Hospital Fair Billing Program, which enforces the Hospital Fair Pricing Act. LA Health Services says the program reviews hospital decisions about whether you qualify for help, and you can file a complaint if you believe you were wrongly denied financial assistance.

File at hospitalbillcomplaint.hcai.ca.gov. The state's Department of Health Care Access and Information (HCAI) also publishes each California hospital's charity care and discount payment policies and applications, which is useful if your bill is from a private hospital.

Coming in 2027: A New County Program for Uninsured Adults

In June 2026, county voters approved Measure ER, a half-cent sales tax to support the health care safety net. According to a July 2026 county release, part of that money will fund a new program for uninsured, low-income adults, built with community clinics. It's expected to start in January 2027 and include primary, specialty, dental and behavioral health care for people who don't qualify for, or lose, Medi-Cal. Eligibility rules were still being decided when we checked, so watch dhs.lacounty.gov for updates.

Closing Thoughts

If you're uninsured or underinsured and getting care at a county hospital or clinic, ask for a Patient Financial Services screening right away. Below 200% FPL, ATP care is free; above it, costs are capped by month and by admission. Apply for Medi-Cal if you might qualify, keep copies of everything you submit, and if you're wrongly denied, file a state complaint.