Patient and consumer advocates are counting on Kamala Harris to accelerate federal efforts to help people struggling with medical debt if she wins the presidential election next month.
And they see the vice president and Democratic candidates as the best hope for preserving Americans’ access to health insurance. Comprehensive coverage that limits patient out-of-pocket costs is the best defense against debt, experts say.
The Biden administration has expanded financial protections for patients, including a landmark proposal from the Consumer Financial Protection Bureau (CFPB) to remove medical debt from consumer credit reports.
In 2022, President Joe Biden also signed the Inflation Reduction Act, which limits the amount Medicare members must pay for prescription drugs, including a $35 per month cap on insulin. And in legislatures across the country, Democrats and Republicans are quietly working together to enact laws to rein in debt collectors.
But supporters say the federal government could do more to address a problem that affects 100 million Americans, forcing many to work more, lose their homes and spend less on food and other essential goods.
“Biden and Harris have done more to address the medical debt crisis in this country than any other administration,” said Mona Shah, senior director of policy and strategy at Community Catalyst, a nonprofit leading national efforts to strengthen medical debt protections. “But there is still much to be done and this must be a priority for Congress and the next administration.”
At the same time, patient advocates worry that if former President Donald Trump wins a second term, he will weaken insurance protections by allowing states to cut their Medicaid programs or reduce federal assistance for Americans to purchase health coverage. This would put millions of people at greater risk of going into debt if they get sick.
In his first term, Trump and congressional Republicans in 2017 attempted to repeal the Affordable Care Act (ACA), a move that independent analysts said would eliminate health coverage for millions of Americans and increase costs for people who have pre-existing diseases such as diabetes and cancer.
Trump and his Republican allies continue to attack the ACA, and the former president has said he wants to repeal the Inflation Reduction Act, which also includes help for low- and middle-income Americans to buy health insurance.
“People will face a wave of medical debt from paying premiums and prescription drug prices,” said Anthony Wright, executive director of Families USA, a consumer group that supports federal health protection. “Patients and society must care.”
Trump’s campaign did not respond to questions about his health agenda. And the former president did not often talk about health care or medical debt on the campaign trail, although he said in a debate last month that he had a “draft plan” to improve the ACA. Trump has not provided details.
Harris has repeatedly promised to protect the ACA and renew expanded subsidies for monthly insurance premiums created by the Inflation Reduction Act. The assistance is scheduled to expire next year.
The vice president also expressed support for increasing government spending to purchase and pay off patients’ old medical debt. In recent years, some states and cities have purchased medical debt on behalf of their residents.
These efforts have relieved the debts of hundreds of thousands of people, although many advocates say eliminating old debts is at best a short-term solution, as patients will continue to rack up bills they can’t pay without more substantive action.
“This is a boat with holes in it,” said Katie Berge, a lobbyist for the Leukemia and Lymphoma Society. The patient group was one of more than 50 organizations that last year sent a letter to the Biden administration urging federal agencies to take more aggressive steps to protect Americans from medical debt.
“Medical debt is no longer a niche issue,” said Kirsten Sloan, who works on federal policy for the American Cancer Society’s Cancer Action Network. “This is key to the economic well-being of millions of Americans.”
The Consumer Financial Protection Bureau is developing regulations that would prohibit medical bills from appearing on consumers’ credit reports, improving credit scores and making it easier for millions of Americans to rent a home, get a job or get a home loan.
Harris, who called medical debt “critical to the financial health and well-being of millions of Americans,” enthusiastically supported the proposed regulations. “No one should lose access to economic opportunity just because they are experiencing a medical emergency,” he said in June.
Harris’ running mate, Minnesota Gov. Tim Walz, who said his own family struggled with medical debt when he was young, signed a state law in June that cracks down on debt collections.
CFPB officials said the regulations will be finalized early next year. Trump has not indicated whether he will continue medical debt protections. In its first term, the CFPB did little to address the problem, and Republicans in Congress have long criticized the watchdog agency.
If Harris wins, many consumer groups want the CFPB to further strengthen its measures, including greater oversight of medical credit cards and other financial products that hospitals and other health care providers have begun offering to patients. For these loans, people are required to pay additional interest on their medical debt.
“We’re seeing a variety of new medical financial products,” said April Kuehnhoff, senior attorney at the National Consumer Law Center. “This may raise new concerns regarding consumer protection, and it is critical that the CFPB and other regulators monitor these companies.”
Some advocates want other federal agencies to get involved as well.
This includes the massive Department of Health and Human Services (HHS), which controls hundreds of billions of dollars through the Medicare and Medicaid programs. The money gives the federal government enormous influence over hospitals and other health care providers.
So far, the Biden administration has not used that leverage to address medical debt.
But in a preview of possible future action, state leaders in North Carolina recently won federal approval for a medical debt initiative that would force hospitals to take steps to relieve patient debt in exchange for government assistance. Harris praised the initiative.
