Nearly 20% of District adults are burdened by unpaid medical bills, and that number could soon increase, according to a report by Tzedek DC, a nonprofit whose mission is to help city residents deal with debt collection and credit issues.
Considering hundreds of billions of dollars in looming Medicaid cuts for Americans and stalled federal reforms, the new report released on June 10 details the problem for District residents and offers solutions for the D.C. Council to implement as a state-level government.
The report, “More Than a Band-Aid: Systemic Changes to Protect DC Residents from Medical Debt,” shows how medical debt drives financial hardship, worsens health outcomes, and deepens racial and economic disparities in the District.
“With Medicaid under attack and federal protections weakening, D.C. must act now to shield our residents,” said Ariel Levinson-Waldman, founding president and director-counsel of Tzedek DC. “Addressing medical debt head-on can help thousands of families regain financial stability and improve health outcomes and make the system fairer and smarter.”
Councilmember Christina Henderson, chair of the D.C. Council Committee on Health, called medical debt a “critical issue” affecting Washingtonians’ “physical, mental, and financial health.”
“Tzedek DC’s medical debt report details the scope of the problem and identifies areas for improvement,” she said. “I look forward to working with my colleagues and stakeholders to reduce medical debt for District residents.”
The report outlines specific policy solutions for the District, including limiting medical debt interest rates, banning medical debt from credit reports, requiring transparency from hospitals’ financial assistance programs, and strengthening enforcement tools and compliance incentives through the DC Office of the Attorney General. In addition, the report recommends reforming harmful medical debt collection tactics such as wage garnishment and property liens against residents’ homes based on medical debt.
Further, the report highlights how medical debt disproportionately impacts Black residents, individuals with disabilities, and mothers, exacerbating D.C.’s severe racial wealth gap. Patients facing medical debt often delay necessary care, worsening chronic conditions, and driving up long-term costs for the community.
“Medical debt is a leading reason people are contacted by debt collectors, disproportionately affecting Black and Latino families. But, unlike other types of debt, medical debt is unpredictable, and that makes it a poor judge of anyone’s creditworthiness,” said Berneta Haynes, senior attorney at the National Consumer Law Center. “People do not plan to get sick or hurt, which is why we support Tzedek DC’s report and their proposals to reduce the burden of medical debt by eliminating credit reporting of medical debt and preventing medical debt from occurring.”
