Capitol Beat

Josh Shapiro calls on PA Senate to pass medical debt relief legislation

The governor’s 2024-25 budget calls for a $4M investment in medical debt relief.

Gov. Josh Shapiro speaks at a press conference on medical debt relief in April 2024.

Gov. Josh Shapiro speaks at a press conference on medical debt relief in April 2024. Commonwealth Media Services

Gov. Josh Shapiro, who has made the elimination of medical debt a key priority of his 2024-25 executive budget proposal, spoke at a community health center in Mifflin County on Tuesday, calling on the Pennsylvania Senate to advance legislation that would bring Shapiro’s medical debt proposal to fruition. 

“No one chooses to have medical debt. No one chooses to undergo heart surgery or get a cancer diagnosis. These Pennsylvanians didn’t do anything wrong, and yet they’re still facing this extraordinary debt,” Shapiro said Tuesday. 

Shapiro was joined by Democratic state Rep. Arvind Venkat, an emergency room physician and legislator who is the prime sponsor of House Bill 78, which would create a medical debt relief program administered by the Pennsylvania Department of Health. Under the legislation, the department would contract with a medical debt relief coordinator that would be tasked with buying and discharging medical debt belonging to eligible state residents. 

Venkat’s legislation passed the House in June 2023 with a vote of 114 to 89, and now awaits a vote from the Senate Health and Human Services Committee.

Shapiro and Venkat were accompanied by Kris McConnell, a Mifflin County resident who said her and her husband are struggling with roughly $13,000 in medical debt – despite both having insurance. McConnell said last year she had a gastrointestinal procedure done and her husband had heart surgery, resulting in $10,000 worth of surgery bills, as well as an additional $3,000 worth of debt from pre-surgical care and follow-up appointments. 

“We began receiving the bills; it was a little overwhelming. The cost was astronomical. The bills were very confusing, hard to interpret. We looked for financial help, but we were at the border of not (being) eligible,” McConnell said. 

“I know that I’m not alone,” she continued. “There are thousands of Pennsylvanians just like me who are suffering in silence, who are just barely getting by because of illnesses, health problems, that derail us into this debt that we just can’t seem to eliminate.”

According to a 2023 national survey sponsored by the American Cancer Society Cancer Action Network, the Leukemia and Lymphoma Society and R.I.P. Medical Debt that polled 2,663 adults in August 2023, 69% of respondents said they experienced difficulty paying medical bills at least some of the time.

In Pennsylvania, the Shapiro administration estimates that the total amount of medical debt in the collections stage was at least $1.8 billion as of December 2020. The governor said a $4 million allocation in this year’s budget could wipe out more than $400 million in existing medical debt.

Venkat, the bill’s prime sponsor, said he has seen the real-world impacts of medical debt as an emergency room physician. “One of the joys of being an ER doc is that I get to care for anyone, no questions asked. But I also get to see the gaps in our health system and in our communities, and medical debt is a prime example of this,” Venkat said at the press conference. “In my nearly 25-year career as an emergency physician, I’ve seen more and more patients who fear seeing a physician due to the cost of health care and the debt that they may accrue.” 

Those eligible for the program include Pennsylvanians whose annual income is 400% of federal poverty limit or less, as well as those who have medical debt that makes up at least 5% of their income. 

Other states have taken similar efforts to reduce and eliminate medical debt, like Connecticut and New Jersey. Connecticut Gov. Ned Lamont, a Democrat, announced in February that the state will cancel approximately $650 million in medical debt, which could benefit more roughly 250,000 Connecticut residents, according to CNN. New Jersey Gov. Phil Murphy secured a $10 million allocation for a medical debt relief initiative in last year’s state budget, and is looking to build on that effort in the state’s next budget, per a report from NJ Spotlight News.

In the commonwealth, with House Bill 78 awaiting committee approval, Shapiro on Tuesday pressed the GOP-controlled Senate to send the bill to his desk. 

“It is now time for the state Senate to take up Rep. Venkat’s bill and pass this in the same bipartisan manner that the House did, get the bill on my desk and let me sign it into law and … help folks who are struggling all across Pennsylvania,” he said.

Kate Flessner, a spokesperson for the Senate Republican Caucus, said the bill is one of several proposals related to health care access that the caucus will review. “We are eager to explore all options to ensure affordable access to health care for individuals throughout the commonwealth,” Flessner said. “This is one of the many proposals which will be a part of our discussions.”