Medical debt has taken hold of millions, prompting both red and blue states to pass laws to help.

Samantha and Ariane Buck have battled medical debt for many years, making life increasingly challenging at times for themselves and their two children. A ballot measure in Arizona to cap interest rates on medical debt passed overwhelmingly with support coming both from Democrats and Republicans alike.
Ash Ponders for KFF Health News*. * To un-hide or show caption, tap here
At a time when abortion and the Affordable Care Act have become hot topics in presidential races, Democrats and Republicans in statehouses across America have been working cooperatively on strategies for alleviating medical debt crises. Since 2021, more than 20 states have enacted new laws designed to curb aggressive hospital billing practices, expand charity care for lower-income patients and rein in debt collectors. Democrats were responsible for most measures passed into law but these legislative efforts often received bipartisan support in passing them through state legislatures. Republican lawmakers led efforts in some states to expand patient protections. “Every significant medical procedure can place someone into bankruptcy, regardless of party, regardless of background,” Florida House Speaker Paul Renner (a conservative Republican) explained in an interview. This issue should not be overlooked or disregarded.”
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Renner, known for leading controversial measures that restrict abortion rights and expand the death penalty in Florida, spearheaded efforts this year to limit when hospitals could send patients directly into collections – garnering unanimous approval in Florida’s legislature. Similar bipartisan efforts in other states went further by barring unpaid medical bills from consumer credit reports or restricting providers from placing liens against patients’ homes. KFF Health News estimated that 100 million U.S. adults currently owe some form of health care debt that forces millions into draining savings accounts or taking out second mortgages or cutting back essential services; one quarter owed over $5,000 as of 2022.
“Republicans in Maryland appear more open than Democrats to protecting individuals against medical debt than from any other form of debt,” according to Marceline White, executive director of Economic Action Maryland in that state, who led efforts against medical providers garnishing low-income patients’ wages with their services – something this bill garnered unanimous approval by both Democrats and Republicans alike. White noted: “There appears to be widespread agreement among members of both political parties that you shouldn’t lose your home or savings simply because you got sick – that is simply basic fairness
Medical debt remains an emotionally charged subject in Washington. Under President Joe Biden’s guidance, several efforts to combat it were implemented including an initiative from Consumer Financial Protection Bureau that proposes barring all medical debt from credit reports. Vice President Harris is leading an administration campaign against medical debt and has highlighted its efforts on presidential campaign trail while calling for additional efforts to help retire health care debt for millions of American. Former President Donald Trump doesn’t typically discuss medical debt when campaigning, but congressional Republicans have strongly objected to the Consumer Financial Protection Bureau proposal; House Financial Services Committee Chairman Patrick McHenry of North Carolina described this move as “regulatory overreach”. Pollster Michael Perry has conducted extensive health care surveys among Americans. According to him, conservative voters who tend to dislike government are viewing medical debt differently than expected. “Patients feel powerless against this system and lack an equal voice to influence decisions about healthcare in this way,” according to Bender. He noted the partisan divides commonly seen during elections are simply absent here. Arizona consumer advocates put forth a ballot measure in 2022 to cap interest rates on medical debt and 72% of voters supported it; nationwide polls also demonstrate over 80% support of Republicans and Democrats alike for limits on debt collections as well as requirements that hospitals provide financial aid to patients.
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Dana Downey and Samuel Comacho attended a roundtable held on Capitol Hill, Washington D.C. by Community Catalyst (a civil rights organization) that called for national action on medical debt issues owed by individuals — more has happened regarding medical debt in individual states however (photo by Tasos Katopodis/Getty Images for Community Catalyst). To read the rest of their conversation click here (Tasos Katopodis/Getty Images for Community Catalyst).
Perry noted an additional factor contributing to bipartisan interest in medical debt: rising mistrust of health systems that continue to expand and act more like large corporations. Hospitals “aren’t what they used to be”, said Perry, and profits and greed seem to drive much decision making within health systems today. Not every state effort at combatting medical debt has enjoyed broad bipartisan backing – for instance when Colorado became the first state last year to bar medical debt from residents’ credit reports only one Republican lawmaker supported it while this year in Minnesota there was not even one Republican lawmaker that supported it! A bill this year passed without receiving one vote from either political sides!
But similar measures have succeeded elsewhere. A 2024 Illinois bill to prohibit credit reporting of medical debt was unanimously approved in both houses of government; no GOP legislator opposed its passing either in Rhode Island nor Illinois. California legislators recently passed a 2021 bill mandating hospitals provide more financial aid for patients in order to pass it unanimously in both houses of their legislature. Even conservative states like Oklahoma are taking small but important steps, with legislation being signed off on by its Republican governor that prohibits medical providers from seeking debt collection from patients for which no prices were made public and passed unanimously through both Houses.
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New Mexico state Sen. Steve Neville, a Republican who sponsored legislation restricting aggressive collections against low-income patients in his state, justified his support by simply being pragmatic. Neville indicated there would not be much value in spending too much time and energy attempting to collect from indigent patients who do not possess sufficient financial means, adding “if they don’t have money then that shouldn’t matter much either way”. Three out of 12 GOP senators supported this measure. Dale Folwell of North Carolina state Treasurer Dale Folwell a Republican state legislator spearheaded an attempt to ban same-sex marriage, has stressed the need for all elected officials from any political affiliation to care about how medical debt impacts patients. Folwell made clear it didn’t matter who said what. KFF Health News provides national reporting about healthcare-related topics as one of its core operating programs at KFF, with KFF Health News itself producing in-depth journalism related to such matters.