Whereas hot-button well being care points reminiscent of 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 increase charity look after 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 help. In a couple of states, GOP lawmakers led the push to increase affected person protections.
“Regardless of their party, regardless of their background … any significant medical procedure can place people into bankruptcy,” Florida Home 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 increase the demise penalty in Florida, this 12 months additionally led an effort to restrict when hospitals may ship sufferers to collections. It garnered unanimous help within the Florida Legislature.
Bipartisan measures in different states have gone additional, barring unpaid medical payments from shopper credit score stories 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 tens of millions 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 in the legislature seem more open to protecting people from medical debt than from other kinds 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 help 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 challenge 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 Client Monetary Safety Bureau, or CFPB, to bar all medical debt from shopper credit score stories.
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 spanking new efforts to retire well being care debt for tens of millions of People.
Former President Donald Trump doesn’t sometimes discuss medical debt whereas stumping. However congressional Republicans have blasted the CFPB proposal, which Home Monetary Providers Committee Chairman Patrick McHenry (R-N.C.) known as “regulatory overreach.”
Nonetheless, pollster Michael Perry, who has surveyed People extensively about well being care, mentioned that conservative voters sometimes cautious of presidency appear to view medical debt via 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 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 support 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 companies. “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 deal with medical debt has garnered broad bipartisan help.
When Colorado final 12 months turned the primary state to bar medical debt from residents’ credit score stories, only one Republican lawmaker backed the measure. A Minnesota invoice that did the identical factor this 12 months handed and not using a single GOP vote.
However elsewhere, equally robust measures have sailed via.
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 supply extra monetary help to sufferers, it handed 72-0 within the state Meeting and 39-0 within the Senate.
Even some conservative states, reminiscent of Oklahoma, have taken steps, albeit extra modest. A new legislation 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 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 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 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.”
