Sponsors (19)
Official title: To amend title XVIII of the Social Security Act to establish certain standards and requirements with respect to financial assistance and medical debt collection for hospitals participating in the Medicare program, and to amend title III of the Public Health Service Act to establish a grant program for purposes of medical debt relief.
Introduced February 10, 2026 by Gabriel Vasquez · Last progress February 10, 2026
The bill substantially reduces medical debt burdens and strengthens protections and transparency for low-income and uninsured patients, but shifts costs and administrative burdens onto hospitals (especially small/rural providers) and concentrates limited federal relief funds, creating risks of higher prices, service reductions, and uneven geographic coverage.
Low- and middle-income households (up to 400% FPL or with medical debt ≥5% of MAGI) can have qualifying medical bills discharged, reducing personal debt burdens and improving financial stability and credit prospects.
Low-income and uninsured patients (especially ≤250% FPL) are protected from aggressive collection actions — e.g., no wage garnishment or home foreclosure, no interest or sale of certain hospital debt — and receive earlier, clearer charity-care screening and appeal rights.
Hospitals must provide clearer billing notices, eligibility criteria, repayment program information, and income-submission instructions, and the program requires federal reporting — giving patients better information and improving oversight and accountability.
Hospitals face substantial compliance costs and the risk of large penalties (up to $1M), costs that are likely to be passed on to patients or taxpayers through higher prices or reduced services.
Smaller and rural hospitals may struggle with the added administrative, IT, and audit burdens, risking reductions in services or even closures in vulnerable communities.
Limiting debt sales and capping repayment/collection options plus expanded discharge could reduce hospitals' ability to recover unpaid bills, tightening budgets for uncompensated care and potentially threatening service levels.
Based on analysis of 3 sections of legislative text.
Strengthens hospital charity-care requirements, limits certain medical debt collection practices, authorizes HHS grants to buy and discharge qualifying medical debt, and authorizes $100M for FY2027.
Requires hospitals participating in Medicare to adopt and follow strengthened charity care, financial assistance, and limits on medical debt collection starting January 1, 2028, and allows HHS to levy civil monetary penalties for noncompliance. Creates a one-recipient Medical Debt Relief Grant Program at HHS to identify, buy, and discharge qualifying medical debt, with $100 million authorized for FY2027 and program rules to be set within one year of enactment.