D.C. Enacts Broad Medical Debt Protections

On August 20, the District of Columbia’s Medical Debt Mitigation Amendment Act of 2026 became effective after being enacted without Mayor Muriel Bowser’s signature. The law establishes new requirements governing medical debt collection, credit reporting, financial assistance, payment plans, and medical financing. Although the law is effective, its substantive provisions remain subject to an applicability provision tied to funding. The District’s FY2027 Budget Support Emergency Act repeals that delay beginning October 1, 2026.

The law imposes several requirements on health care facilities, providers, and entities collecting medical debt. Specifically, the law:

• Requires financial assistance. Covered health care facilities must provide free medically necessary care to patients with household income at or below 200% of the federal poverty level and discounted care for patients with household income between 200% and 500%. Eligible patients receiving discounted care must also be offered