Mapping State Efforts to Address Medical Debt

Heather Howard and Laura Buddenbaum, SHVS

The healthcare affordability crisis has resulted in an estimated 100 million Americans, or 41% of adults, holding some form of medical debt. The consequences of medical debt are profound, from financial strain to worsened health outcomes, as people delay or forgo health services and medications to prevent further debt. Medical debt also has significant health equity implications as there is a disproportionate impact on those with low incomes, poor health status, and communities of color such as Black and Latino/a populations.

This is a “uniquely American problem,” but fortunately, states are moving to eradicate medical debt for low income residents, which testimonials show dramatically improves recipients’ quality of life. At the same time, states are also working to protect residents from the financial consequences of medical debt by prohibiting its inclusion in credit reports. In January 2025, the Consumer Financial Protection Bureau (CFPB) finalized a rule that removes medical debt from all credit reports and prohibits lenders from considering medical debt information when determining a consumer’s eligibility for credit. On February 6, a judge for the United District Court for the Eastern District of Texas issued a stay on the rule, delaying the effective date to June. While implementation of the rule is on hold, policymakers at the state level are enacting their own laws and fortifying protections for consumers against medical debt.

The map below highlights state action to cancel medical debt and/or prohibit medical debt reporting. For more information, see this Health Affairs Forefront article which examines the burgeoning trend of state efforts to cancel medical debt for just pennies on the dollar. For other state policy options to address medical debt, see research from the Commonwealth Fund.

Map updated as of: 3/7/2025