Policy Resolution HHS-26-08

WHEREAS, the National Black Caucus of State Legislators (NBCSL) recognizes that medical debt is a leading cause of financial hardship and disproportionately affects Black communities and other communities of color;

WHEREAS, over 100 million people in the United States struggle with medical debt, with Black adults nearly twice as likely as White adults to owe medical debt, even when insured, according to a study by the National Institutes of Health;

WHEREAS, 47% of cancer patients and survivors incurred medical debt to pay for their cancer care and those with cancer debt are more than three times as likely to be behind on screenings, according to the American Cancer Society;

WHEREAS, according to the Kaiser Family Foundation, analysis shows that 13% of Black Americans report having medical debt, compared to 8% of White and 3% of Asian Americans;

WHEREAS, aggressive medical debt collection practices, including lawsuits, wage garnishments, and credit reporting, exacerbate economic disparities and undermine public health;

WHEREAS, the Consumer Financial Protection Bureau has shown that nonprofit hospitals, many of which receive tax exemptions are legally obligated to provide financial assistance but often fail to adequately inform patients or implement fair policies;

WHEREAS, state legislatures have the authority and an interest in protecting consumers from medical debt and responsibility to regulate hospital billing practices, require standardized financial assistance policies, and protect consumers from predatory medical debt collection;

WHEREAS, health insurance plans should disclose to the patient whether or not a copay accumulator adjustment program will be applied to the enrollee’s cost-sharing obligations; and

WHEREAS, this resolution reinforces NBCSL’s commitment to patient protection and affordability, aligning with HHS-24-28, HHS-22-27, and HHS-19-31, which promoted cost transparency, preventive care access, and financial support for patients.

THEREFORE BE IT RESOLVED, that the National Black Caucus of State Legislators (NBCSL) urges state legislatures to adopt comprehensive medical debt protection laws, that include, but are not limited to standardized hospital financial assistance policies, prohibitions on aggressive collection practices, public reporting of hospital financial assistance and collection practices, state oversight of nonprofit hospital compliance with charity care obligations, and credit reporting protections;

BE IT FURTHER RESOLVED, that the NBCSL supports state-level reforms requiring hospitals to provide transparency in medical billing, financial support, and charity care, as well as to offer income- and family-size-based financial assistance programs, co-pay accumulator programs, payment plan options, and comprehensive education on patient rights;

BE IT FURTHER RESOLVED, that the NBCSL believes if a prescribed drug is the only medically appropriate treatment for a condition, the enrollee’s cost-sharing obligations (i.e., Co-pay or deductible) should be adjusted to account for third-party financial assistance, regardless of whether a generic equivalent is available and the prescribing provider may submit documentation of medical necessity, and the health plan should be required to honor the third-party assistance in the absence of a generic alternative;

BE IT FURTHER RESOLVED, that the NBCSL urges state legislatures to examine medical debt and harmful consumer practices and to enact state legislation to protect patients; and

BE IT FINALLY RESOLVED, that a copy of this resolution be transmitted to the President of the United States, the Vice President of the United States, members of the United States House of Representatives and the United States Senate, and other federal and state government officials as appropriate.

• Resolution ID: HHS-26-08
• Sponsored by: Rep. John King (SC)
• Policy Committee: Health and Human Services Policy Committee