Patient and consumer advocates are banking on Kamala Harris to accelerate federal efforts to help people struggling with medical debt if she wins in next month’s presidential election.
And they see the vice president and Democratic candidate as the best hope for preserving Americans’ access to health insurance. Comprehensive coverage that limits patients’ 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 by the Consumer Financial Protection Bureau (CFPB) to remove medical debt from consumers’ credit reports.
In 2022, President Joe Biden also signed the Inflation Reduction Act, which limits how much Medicare members must pay for prescription drugs, including a cap of $35 a month for insulin. And in legislatures across the country, Democrats and Republicans have quietly worked together to enact laws to rein in debt collectors.
But advocates 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 reduce spending on food and other essential items.
“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 that has led national efforts to strengthen protections against medical debt. “But there is more to do and it should be a priority for the next Congress and administration.”
At the same time, patient advocates fear that if former President Donald Trump wins a second term, he will weaken insurance protections by allowing states to cut their Medicaid programs or reducing federal help for Americans to buy health coverage. That would put millions of people at greater risk of going into debt if they get sick.
In his first term, Trump and congressional Republicans attempted in 2017 to repeal the Affordable Care Act (ACA), a move that independent analysts say would have stripped health coverage from millions of Americans and increased costs. for people with pre-existing conditions, such as diabetes and cancer.
Trump and his GOP allies continue to attack the ACA, and the former president has said he wants to roll back 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 prescription drug premiums and prices,” said Anthony Wright, executive director of Families USA, a consumer group that has supported federal health protections. “Patients and the public should be concerned.”
Trump’s campaign did not respond to questions about his health agenda. And the former president doesn’t often talk about health care or medical debt on the campaign trail, although he said in last month’s debate that he had “concepts of a plan” to improve the ACA. Trump has not offered details.
Harris has repeatedly promised to protect the ACA and renew the expanded subsidies for monthly insurance premiums created by the Inflation Reduction Act. That aid is scheduled to expire next year.
The vice president has also expressed support for increased government spending to purchase and pay off patients’ old medical debt. In recent years, several states and cities have purchased medical debt on behalf of their residents.
These efforts have relieved debt for hundreds of thousands of people, although many advocates say canceling old debt is a short-term solution at best, as patients will continue to rack up bills they can’t pay without action. more substantive.
“It’s a boat with a hole in it,” said Katie Berge, a lobbyist for the Leukemia and Lymphoma Society. This patient group was one of more than 50 organizations that last year sent letters 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 problem,” said Kirsten Sloan, who works on federal policy for the American Cancer Society Cancer Action Network. “It 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. a car.
Harris, who has called medical debt “critical to the financial health and well-being of millions of Americans,” enthusiastically supported the regulation proposal. “No one should be deprived of access to economic opportunity simply because they experienced a medical emergency,” he said in June.
Harris’ running mate, Minnesota Gov. Tim Walz, who has said his own family struggled with medical debt when he was young, signed a state law in June that represses debt collection.
CFPB officials said the regulations will be finalized early next year. Trump has not indicated whether he would move forward with protections against medical debt. In its first term, the CFPB did little to address it, and Republicans in Congress have long criticized the regulatory agency.
If Harris wins, many consumer groups want the CFPB to further strengthen measures, including greater oversight of medical credit cards and other financial products that hospitals and other medical providers have begun offering to patients. For these loans, people are required to pay additional interest on their medical debt.
“We are seeing a variety of new medical financial products,” said April Kuehnhoff, senior attorney at the National Consumer Law Center. “These may raise new concerns about consumer protections, and it is critical that the CFPB and other regulators monitor these companies.”
Some advocates want other federal agencies to get involved, too.
This includes the enormous Department of Health and Human Services (HHS), which controls hundreds of billions of dollars through the Medicare and Medicaid programs. That money gives the federal government enormous influence over hospitals and other medical providers.
So far, the Biden administration has not used that leverage to address medical debt.
But in a possible preview of future action, state leaders in North Carolina recently won federal approval for a medical debt initiative that will force hospitals to take steps to relieve patients’ debts in exchange for government aid. Harris praised the initiative.
nlevey@kff.org,
@NoamLevey
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