While hot-button health care issues such as abortion and the Affordable Care Act roil the presidential race, Democrats and Republicans in statehouses around the country have been quietly working together to tackle the nation鈥檚 medical debt crisis.
New laws to curb aggressive hospital billing, to expand charity care for lower-income patients, and to rein in debt collectors have been enacted in more than 20 states since 2021.
Democrats championed most measures. But the legislative efforts often passed with Republican support. In a few states, GOP lawmakers led the push to expand patient protections.
鈥淩egardless of their party, regardless of their background ... any significant medical procedure can place people into bankruptcy,鈥� Florida House Speaker Paul Renner, a conservative Republican, said in an interview. 鈥淭his is a real issue.鈥�
Renner, who has shepherded controversial measures to curb abortion rights and expand the death penalty in Florida, this year also led an effort to limit when hospitals could send patients to collections. It garnered unanimous support in the Florida Legislature.
Bipartisan measures in other states have gone further, barring unpaid medical bills from consumer credit reports and restricting medical providers from placing liens on patients鈥� homes.
About 100 million people in the U.S. are burdened by some form of health care debt, forcing millions to drain savings, take out second mortgages, or cut back on food and other essentials, . A quarter of those with debt owed more than $5,000 in 2022.
鈥淩epublicans in the legislature seem more open to protecting people from medical debt than from other kinds of debt,鈥� said , executive director of Economic Action Maryland, which helped lead efforts in that state to stop medical providers from garnishing the wages of low-income patients. drew unanimous support from Democrats and Republicans
鈥淭here seems to be broad agreement that you shouldn鈥檛 lose your home or your life savings because you got ill,鈥� White said. 鈥淭hat鈥檚 just a basic level of fairness.鈥�
Medical debt remains a more polarizing issue in Washington, where the Biden administration has pushed several efforts to tackle the issue, including a by the Consumer Financial Protection Bureau, or CFPB, to bar all medical debt from consumer credit reports.
Vice President Harris, who is spearheading the administration鈥檚 medical debt campaign, has touted the work on the presidential campaign trail while calling for new efforts to retire health care debt for millions of Americans.
Former President Donald Trump doesn鈥檛 typically talk about medical debt while stumping. But congressional Republicans have blasted the CFPB proposal, which House Financial Services Committee Chairman Patrick McHenry (R-N.C.) called 鈥渞egulatory overreach.鈥�
Nevertheless, pollster Michael Perry, who has surveyed Americans extensively about health care, said that conservative voters typically wary of government seem to view medical debt through another lens. 鈥淚 think they feel it鈥檚 so stacked against them that they, as patients, don鈥檛 really have a voice,鈥� he said. 鈥淭he partisan divides we normally see just aren鈥檛 there.鈥�
When Arizona consumer advocates put a in 2022 to cap interest rates on medical debt, 72% of voters backed the initiative.
Similarly, nationwide polls have found more than 80% of Republicans and Democrats back limits on medical debt collections and stronger requirements that hospitals provide financial aid to patients.
Perry surfaced something else that may be driving bipartisan interest in medical debt: growing mistrust as health systems get bigger and act more like major corporations. 鈥淗ospitals aren鈥檛 what they used to be,鈥� he said. 鈥淭hat is making it clear that profit and greed are driving lots of the decision-making.鈥�
Not every state effort to address medical debt has garnered broad bipartisan support.
When Colorado last year became to bar medical debt from residents鈥� credit reports, just one Republican lawmaker backed the measure. A that did the same thing this year passed without a single GOP vote.
But elsewhere, similarly tough measures have sailed through.
A 2024 to bar credit reporting for medical debt passed unanimously in the state Senate and cleared the House of Representatives 109-2. In Rhode Island, not a single GOP lawmaker opposed a .
And when the California Legislature took up to require hospitals in the state to provide more financial assistance to patients, it passed 72-0 in the state Assembly and 39-0 in the Senate.
Even some conservative states, such as Oklahoma, have taken steps, albeit more modest. A there bars medical providers from pursuing patients for debts if the provider has not publicly posted its prices. The measure, signed by the state鈥檚 Republican governor, passed unanimously.
New Mexico state Sen. Steve Neville, a Republican who aggressive collections against low-income patients in that state, said he was simply being pragmatic.
鈥淭here was not much advantage to spending a lot of time trying to do collections on indigent patients,鈥� Neville said. 鈥淚f they don't have the money, they don't have the money.鈥� 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, said all elected officials, no matter their party, should care about what medical debt is doing to patients.
鈥淚t doesn鈥檛 matter if, as a conservative, I鈥檓 saying these things, or if Bernie Sanders is saying these things,鈥� Folwell said, referencing Vermont鈥檚 liberal U.S. senator. 鈥淎t the end of the day, it should be all our jobs to advocate for the invisible.鈥�
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