Noam N. Levey
While hot-button well being care points reminiscent of abortion and the Affordable Care Act roil the presidential race, Democrats and Republicans in statehouses across the nation have been quietly working collectively to sort out the nation’s medical debt disaster.
New legal guidelines to curb aggressive hospital billing, to broaden charity take care of lower-income sufferers, and to rein in debt collectors have been enacted in additional than 20 states since 2021.
Democrats championed most measures. But the legislative efforts usually handed with Republican assist. In a couple of states, GOP lawmakers led the push to broaden affected person protections.
“Regardless of their party, regardless of their background … any significant medical procedure can place people into bankruptcy,” Florida House Speaker Paul Renner, a conservative Republican, mentioned in an interview. “This is a real issue.”
Renner, who has shepherded controversial measures to curb abortion rights and broaden the loss of life penalty in Florida, this yr additionally led an effort to restrict when hospitals might ship sufferers to collections. It garnered unanimous assist within the Florida Legislature.
Bipartisan measures in different states have gone additional, barring unpaid medical payments from client credit score reviews and proscribing medical suppliers from inserting liens on sufferers’ properties.
About 100 million individuals within the U.S. are burdened by some type of well being care debt, forcing thousands and thousands to empty financial savings, take out second mortgages, or reduce on meals and different necessities, KFF Health News has found. 1 / 4 of these with debt owed greater than $5,000 in 2022.
“Republicans in the legislature seem more open to protecting people from medical debt than from other kinds of debt,” mentioned Marceline White, govt director of Economic Action Maryland, which helped lead efforts in that state to cease medical suppliers from garnishing the wages of low-income sufferers. That bill drew unanimous assist from Democrats and Republicans
“There seems to be broad agreement that you shouldn’t lose your home or your life savings because you got ill,” White mentioned. “That’s just a basic level of fairness.”
Medical debt stays a extra polarizing difficulty in Washington, the place the Biden administration has pushed a number of efforts to sort out the problem, together with a proposed rule by the Consumer Financial Protection Bureau, or CFPB, to bar all medical debt from client credit score reviews.
Vice President Kamala Harris, who’s spearheading the administration’s medical debt marketing campaign, has touted the work on the presidential marketing campaign path whereas calling for brand new efforts to retire well being care debt for thousands and thousands of Americans.
Former President Donald Trump doesn’t sometimes speak about medical debt whereas stumping. But congressional Republicans have blasted the CFPB proposal, which House Financial Services Committee Chairman Patrick McHenry (R-N.C.) known as “regulatory overreach.”
Nevertheless, pollster Michael Perry, who has surveyed Americans extensively about well being care, mentioned that conservative voters sometimes cautious of presidency appear to view medical debt by one other lens. “I think they feel it’s so stacked against them that they, as patients, don’t really have a voice,” he mentioned. “The partisan divides we normally see just aren’t there.”
When Arizona client advocates put a measure on the ballot in 2022 to cap rates of interest on medical debt, 72% of voters backed the initiative.
Similarly, nationwide polls have discovered greater than 80% of Republicans and Democrats again limits on medical debt collections and stronger necessities that hospitals present monetary assist to sufferers.
Perry surfaced one thing else which may be driving bipartisan curiosity in medical debt: rising distrust as well being methods get larger and act extra like main firms. “Hospitals aren’t what they used to be,” he mentioned. “That is making it clear that profit and greed are driving lots of the decision-making.”
Not each state effort to handle medical debt has garnered broad bipartisan assist.
When Colorado final yr turned the first state to bar medical debt from residents’ credit score reviews, only one Republican lawmaker backed the measure. A Minnesota bill that did the identical factor this yr handed with no single GOP vote.
But elsewhere, equally powerful measures have sailed by.
A 2024 Illinois bill to bar credit score reporting for medical debt handed unanimously within the state Senate and cleared the House of Representatives 109-2. In Rhode Island, not a single GOP lawmaker opposed a credit reporting ban.
And when the California Legislature took up a 2021 bill to require hospitals within the state to offer extra monetary help to sufferers, it handed 72-0 within the state Assembly and 39-0 within the Senate.
Even some conservative states, reminiscent of Oklahoma, have taken steps, albeit extra modest. A new law there bars medical suppliers from pursuing sufferers for money owed if the supplier has not publicly posted its costs. The measure, signed by the state’s Republican governor, handed unanimously.
New Mexico state Sen. Steve Neville, a Republican who backed legislation to restrict aggressive collections towards low-income sufferers in that state, mentioned he was merely being pragmatic.
“There was not much advantage to spending a lot of time trying to do collections on indigent patients,” Neville mentioned. “If they don’t have the money, they don’t have the money.” Three of 12 GOP senators supported the measure.
North Carolina state Treasurer Dale Folwell, a Republican who as a state legislator spearheaded a 2012 effort to ban same-sex marriage, mentioned all elected officers, irrespective of their occasion, ought to care about what medical debt is doing to sufferers.
“It doesn’t matter if, as a conservative, I’m saying these things, or if Bernie Sanders is saying these things,” Folwell mentioned, referencing Vermont’s liberal U.S. senator. “At the end of the day, it should be all our jobs to advocate for the invisible.”
KFF Health News is a nationwide newsroom that produces in-depth journalism about well being points and is among the core working applications at KFF—an impartial supply of well being coverage analysis, polling, and journalism. Learn extra about KFF.
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