HARTFORD, CT – State legislators are working on a bill that they say would combat the rise in medical debt in Connecticut, but hospitals have questions and concerns about how it will be implemented.
At a news conference Monday at the Legislative Office Building, legislators and advocates from Health Equity Solutions (HES) shared their support for House Bill 5320, which would require all nonprofit hospitals in the state (which make up a large portion of Connecticut hospitals) to have a standardized financial assistance application form.
Monday’s event was organized by HES, which is a Hartford-based nonprofit that advocates for equity in healthcare for individuals regardless of gender, race, or economic status.
There is some resistance to the bill from hospitals around the state, as well as the Connecticut Hospital Association.
State Comptroller Sean Scanlon said that the push for healthcare equity needs to go further, and referenced the “Healthcare Cabinet” that his office put together last year. Medical debt, he said, can destroy lives at any moment.
“That fragile ecosystem that all of us sometimes take for granted of owning a house and having a steady job; having our kids enough food on the table. All of that can be threatened in one moment by a terrible car accident, a heart attack, a stroke, or a terminal disease like cancer,” Scanlon said.
Certain applicants who are enrolled in SNAP or WIC, or who are at or below 250% of the federal poverty level, would automatically qualify. HES Executive Director Ayesha Clarke said that the only change under the bill would be creating a common application for financial assistance that would be accepted by all hospitals in the state and requiring hospitals to report how much financial help they provide to patients.
The bill would also include provisions for reasonable payment plans, so patients who do not receive assistance are not driven to bankruptcy.
Rep. Josh Elliott, D-Hamden, said that the legislation is meant “to ensure that people who have access to this help can actually get it.” The fear of debt, he said, keeps people from going to get help in the first place.
According to HES, 72% of medical debt comes from short-term treatments, and increasing financial assistance would increase the rate of residents who do not qualify for Medicaid coming in for treatment.
Sen. Saud Anwar, a Democrat from South Windsor who is also a medical doctor, said that one in 10 people in Connecticut have some form of medical debt, and that 67% of debt in the state comes from medical debt.
“There is no reason that the numbers should be as high as they are,” Anwar said. “We have a responsibility to be able to address this.”
Anwar said that hospitals agree with the intent of the bill, but that there will be negotiations about certain language and provisions that could be removed/included. The original version of the bill included language that named the Attorney General’s office as a possible enforcement agent for the legislation. There is also discussion of including language that would have the AG’s office oversee the hospitals’ reporting of their financial assistance data. But that language is not currently in the bill, according to Clarke.
Still, there is some hesitance from hospitals on the bill.
The Connecticut Hospital Association said in a written statement that Connecticut “leads the nation” in financial assistance for medical patients, and “has some of the strongest patient protections in the nation” regarding surprise billing.
“Hospitals strive to offer clear and meaningful pricing information, patient resources to assist in the bill payment process, and free and discounted care for uninsured individuals,” the statement read. “In total, Connecticut hospitals provided over $130 million in charity care through these efforts in 2022.”
The statement continued:
“A comprehensive approach to protecting patients from medical debt would go beyond what is currently being debated to address high-deductible health plans that shift cost from health insurance companies to patients and the ever-increasing cost of prescription drugs. Connecticut hospitals remain committed to supporting solutions to reducing medical debt and its associated burdens.”
The association had previously submitted testimony on the bill citing issues with certain provisions. Specifically, the association said that a common financial assistance application between all hospitals would be difficult to maintain, because of the range of assistance that can be provided, as well as assistance programs changing.
“This bill imposes unnecessary and burdensome reporting requirements that add to hospitals’ administrative expenses and, ultimately, the cost of care, while also authorizing the Attorney General to investigate the application of hospital financial assistance policies,” the testimony said.
The organization said in its testimony that it is in favor of Senate Bill 395, which would prevent medical debt from being reported to a credit agency.
