A state House bill that originally sought to relieve some Pennsylvanians’ medical debt now has a different goal: making it easier for those in need to access health care financial-aid programs.
Patient advocates acknowledged that they wished the bill, which was amended in a Wednesday meeting of the state House Health committee, still offered direct relief for indebted households. But they said the new version still represented an improvement on the status quo.
“While definitely it would have been amazing to keep the relief portion in the bill — something that could obviously help people with existing debts — we're still really happy to see that some form did pass,” said Jessica Foster, deputy policy and partnership director for the Pennsylvania Health Access Network.
The change to House Bill 79 was made by its sponsor, state Rep. Arvind Venkat (D-McCandless), who said the revision would help prevent medical debt from accruing in the first place.
“Frankly, most patients and even clinicians like myself don't know the details of and how patients can be connected with [hospital] financial assistance programs,” Venkat, who is an emergency physician, told WESA. “It also requires [health systems] to report that to the Department of Health, who will then display it on their website, so the public will also be aware.”
Medical bills would be held in a “pending” status until a patient’s financial eligibility for help is determined. That, Venkat said, “is really a big way to prevent the accumulation of medical debt.”
His amended bill received unanimous bipartisan support and will now move to the House floor for a vote later this session.
As many as four in ten Pennsylvanians have medical debt, said PHAN, which works to expand affordable health care. And the original version of HB79 would have made Pennsylvanians eligible for relief if they carried medical debt that amounted to 5% or more of their household income, or if that income level was at or below 400% of the federal poverty line.
But Venkat said the effectiveness of the program would have been limited by the fact that fewer Pennsylvania health systems send patient medical bills to collections agencies in the first place. UPMC and Allegheny Health Network, Pittsburgh’s major two health systems, have policies that prevent them from selling medical debt to third parties. As WESA previously reported, that makes it hard for either private entities or the government to buy the debt.
And while the original version of Venkat’s bill had several House Republican cosponsors, including Andrew Kuzma of Elizabeth Township, debt relief faced political challenges too.
A debt-relief bill similar to the original version of HB79 passed the House with a comfortable bipartisan majority in 2023. But it stalled in the Senate after being referred to committee.
Gov. Josh Shapiro later sought to include a $4 million allocation in last year’s $47.6 billion budget debate, a move that could have rekindled debate over the measure. Because debt-collection agencies are often willing to accept pennies on the dollar, Shapiro said last April, the money could have been used to buy up to $400 million of debt, which he said could “erase nearly a quarter of all medical debt relief for Pennsylvanians.” But the Senate did not act, and the $4 million was not included in the final budget proposal.
Venkat’s newly amended bill may fare better.
The Hospital and Healthsystem Association of Pennsylvania (HAP), the advocacy organization for health care companies, previously wouldn’t comment directly on the version of the bill that included debt relief. But in a statement Wednesday, the group said that it supports the amendment and is “neutral” on the bill overall. It also noted that Pa. hospitals provided $774 million “in uncompensated care” in 2023 – an amount the statement said proves their commitment to working with patients and their families.
HAP also sent a letter to Health committee members ahead of Wednesday’s vote. The association said it was glad to have collaborated with lawmakers “in developing compromise language included … that takes into consideration financial assistance programs in place and currently offered by hospitals.”
Also on Wednesday, another amended bill received a unanimous vote from the Health committee: Republican Bryan Cutler of Lancaster is seeking a prescription drug repository program to avoid wasting unused meds by allowing them to be dispensed to others instead.
Cutler's measure originally was written specifically for cancer drugs. But the updated bill will cover all unexpired prescription drugs “to be re-dispensed to patients who are indigent by pharmacies approved by the Pharmacy Board."
Cutler told the committee the legislation had its origins in a conversation with a constituent whose "wife had passed away and he had a whole host of not just cancer drugs ... but also non-cancer drugs that were very expensive. Ultimately he was told to waste all of those."
Participation in the program would be voluntary, he said, but it would offer an "opportunity for individuals and families who may have lost loved ones ... to take something from their experience and their loss and then pass it on to someone else."
