Medical Debt Elimination Policy Tracker

With two in every five adults behind on medical bills that total more than $220 billion, soaring medical debt is a national crisis—one that disproportionately burdens low-income people and communities of color. Recognizing the profound impact of medical debt on both health and financial security, Cook County, Illinois allocated $12 million of its American Rescue Plan Act (ARPA) recovery funds in July  2022 to erase up to $1 billion in medical debt.* Toledo, Ohio quickly followed suit, launching a policy trend that now stretches from California to Florida.

As part of our research into how public investments are advancing racial and economic equity, we’ve been tracking the steps local and state governments are taking to confront medical debt through debt cancellation and additional strategies. To capture these efforts, we created a comprehensive database that compiles key information on each effort including its status, the amount of public funding, anticipated impacts, approval dates, and outcomes to date.

Our review of these efforts finds that as of April 29, 2026:

• 29 state and local governments across 18 states and the District of Columbia have dedicated $116.1 million in public funds to medical debt relief programs. 
• Collectively, these initiatives initially promised to deliver $15.8 billion in debt relief to about 6.3 million low- and moderate-income residents. 
• Already, 27 of these programs have abolished more than $13.5 billion worth of medical debt, reaching nearly 7.2 million residents.

With recovery funding winding down, state and local leaders are continuing to push medical debt cancellation forward while developing new strategies to prevent medical debt from occurring and protect people from its negative impacts. North Carolina and Los Angeles County were the first places to launch comprehensive initiatives combining immediate debt relief with additional prevention and protection strategies.

Since our last update, one new state has introduced legislation to cancel medical debt. California Treasurer Fiona Ma’s bill would establish a medical debt relief program within the California Health Facilities Financing Authority. We are also following Washington DC’s ambitious policy proposal to strengthen hospital financial assistance policies, restrict harmful debt collection practices, and increase transparency. Both proposals are currently moving through the committee process.

Explore the map below to learn about each effort, and find our 2024 analysis here. You can also read our policy brief and case studies of medical debt cancellation efforts in Toledo and Columbus and watch our medical debt webinars.

* Cook County subsequently reduced this allocation to $9 million, as reflected in the map below.