Whereas hot-button well being care points resembling abortion and the Inexpensive 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. However the legislative efforts usually handed with Republican assist. In a couple of states, GOP lawmakers led the push to broaden affected person protections.
“No matter their social gathering, no matter their background … any important medical process can place individuals into chapter 11,” Florida Home Speaker Paul Renner, a conservative Republican, mentioned in an interview. “It is a actual concern.”
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 may 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 shopper credit score reviews and limiting medical suppliers from putting liens on sufferers’ properties.
About 100 million individuals within the U.S. are burdened by some type of well being care debt, forcing hundreds of thousands to empty financial savings, take out second mortgages, or in the reduction of on meals and different necessities, KFF Well being Information has discovered. 1 / 4 of these with debt owed greater than $5,000 in 2022.
“Republicans within the legislature appear extra open to defending individuals from medical debt than from other forms of debt,” mentioned Marceline White, govt director of Financial Motion Maryland, which helped lead efforts in that state to cease medical suppliers from garnishing the wages of low-income sufferers. That invoice drew unanimous assist from Democrats and Republicans
“There appears to be broad settlement that you simply shouldn’t lose your house or your life financial savings since you bought unwell,” White mentioned. “That’s only a primary stage of equity.”
Medical debt stays a extra polarizing concern in Washington, the place the Biden administration has pushed a number of efforts to sort out the difficulty, together with a proposed rule by the Shopper Monetary Safety Bureau, or CFPB, to bar all medical debt from shopper 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 hundreds of thousands of Individuals.
Former President Donald Trump doesn’t sometimes speak about medical debt whereas stumping. However congressional Republicans have blasted the CFPB proposal, which Home Monetary Providers Committee Chairman Patrick McHenry (R-N.C.) referred to as “regulatory overreach.”
However, pollster Michael Perry, who has surveyed Individuals extensively about well being care, mentioned that conservative voters sometimes cautious of presidency appear to view medical debt by one other lens. “I believe they really feel it’s so stacked in opposition to them that they, as sufferers, don’t actually have a voice,” he mentioned. “The partisan divides we usually see simply aren’t there.”
When Arizona shopper advocates put a measure on the poll in 2022 to cap rates of interest on medical debt, 72% of voters backed the initiative.
Equally, 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 that could be driving bipartisan curiosity in medical debt: rising distrust as well being programs get larger and act extra like main firms. “Hospitals aren’t what they was once,” he mentioned. “That’s making it clear that revenue and greed are driving numerous the decision-making.”
Not each state effort to handle medical debt has garnered broad bipartisan assist.
When Colorado final yr grew to become the primary state to bar medical debt from residents’ credit score reviews, only one Republican lawmaker backed the measure. A Minnesota invoice that did the identical factor this yr handed with out a single GOP vote.
However elsewhere, equally robust measures have sailed by.
A 2024 Illinois invoice to bar credit score reporting for medical debt handed unanimously within the state Senate and cleared the Home of Representatives 109-2. In Rhode Island, not a single GOP lawmaker opposed a credit score reporting ban.
And when the California Legislature took up a 2021 invoice to require hospitals within the state to offer extra monetary help to sufferers, it handed 72-0 within the state Meeting and 39-0 within the Senate.
Even some conservative states, resembling Oklahoma, have taken steps, albeit extra modest. A brand new regulation 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 laws to limit aggressive collections in opposition to low-income sufferers in that state, mentioned he was merely being pragmatic.
“There was not a lot benefit to spending quite a lot of time attempting to do collections on indigent sufferers,” Neville mentioned. “In the event that they don’t have the cash, they don’t have the cash.” 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 social gathering, ought to care about what medical debt is doing to sufferers.
“It doesn’t matter if, as a conservative, I’m saying these items, or if Bernie Sanders is saying these items,” Folwell mentioned, referencing Vermont’s liberal U.S. senator. “On the finish of the day, it needs to be all our jobs to advocate for the invisible.”
KFF Well being Information is a nationwide newsroom that produces in-depth journalism about well being points and is likely one of the core working packages at KFF—an impartial supply of well being coverage analysis, polling, and journalism. Be taught extra about KFF.
