The DC Council on Tuesday approved major medical debt reform legislation shaped by recommendations from Tzedek DC, advancing new protections for District residents facing medical debt and collection actions.
The Medical Debt Mitigation Amendment Act, introduced by Councilmember Christina Henderson, will, once it takes effect, prohibit medical debt from credit reports, cap interest rates, and require hospitals to screen patients for financial assistance before sending bills to collections. The legislation passed unanimously on final vote and now heads to the Mayor for signature.
Since the bill’s introduction, Tzedek DC has pushed for its passage through public testimony, supporting residents in telling their stories, meetings with Councilmembers, and continued outreach around the impact medical debt is having on District residents.
The bill responds to and implements key recommendations from Tzedek DC’s 2025 report, “More Than a Band-Aid: Systemic Changes to Protect DC Residents from Medical Debt,” which documented how medical debt is affecting residents across the District and outlined policy recommendations now reflected in the legislation.
According to the report, 90,000 or more District residents carry medical debt. Tzedek DC found that many residents delayed care, struggled to secure housing or employment, or faced aggressive collection actions after a medical emergency or illness.
A Racial Equity Impact Assessment released by the DC Council's Office of Racial Equity found the bill is likely to advance racial equity in the District, citing data showing Black and Latine residents are twice as likely as white residents to carry medical debt and to face debt collection actions.
“Today’s vote by the Council is a major step forward for District residents who have been forced to choose between their health and their financial stability,” said Ariel Levinson-Waldman, Tzedek DC’s Founding Director. “Medical debt can follow someone long after they leave the hospital, affecting where they live, whether they can get approved for credit, and even whether they seek care in the future. This bill begins to change that.”
The legislation clarifies how nonprofit hospitals and other covered facilities must offer free or reduced-cost care to eligible patients and create income-based payment plans before pursuing medical debt collections. It also places new restrictions on lawsuits, wage garnishment, and liens on residents’ homes from medical debt.
Maryland and Virginia have enacted similar medical debt protections, and advocates say the District’s legislation would position DC among a growing number of jurisdictions taking action as medical debt continues to rise nationwide.
To read Tzedek DC’s report on how medical debt affects DC residents, click here. Tzedek DC has been working to reform DC’s medical debt system for more than five years, with significant leadership on the issue provided by Jennifer Holloway, Staff Attorney and leader of Tzedek DC’s Medical Debt Project.
About Tzedek DC, Our Medical Debt Work, and the Health Equity Fund
Tzedek DC’s name is drawn from the ancient Jewish teaching “Tzedek, tzedek tirdof,” or “Justice, justice you shall pursue.” Headquartered at the University of the District of Columbia David A. Clarke School of Law, and with offices also in Ward 8, Tzedek DC is a nonprofit organization. Our mission is to safeguard the legal rights and financial health of DC residents with lower incomes facing the often-devastating consequences of debt collection and credit-related obstacles, including those arising from medical debt. This mission is carried out as anti-racism work in response to the massive wealth gaps tracking race in DC and nationwide. Tzedek DC seeks to serve and empower its client base, which is comprised of 90% Black residents, 60% women, and 25% disabled community members. Our strategic approach combines three synergistic activities: (i) free direct services—legal representation and advice, and financial counseling; (ii) working in coalition to make systemic change; and (iii) providing bilingual community legal education on debt collection, identity theft, and credit management. Since launching in 2017, Tzedek DC has served over 6,500 households and catalyzed systemic change benefiting hundreds of thousands of DC community members.
A portion of Tzedek DC’s medical debt work is funded by the Health Equity Fund, as administered by the Greater Washington Community Foundation in partnership with the Health Equity Committee. The Health Equity Fund is designated to improve the health outcomes and health equity of residents of the District of Columbia. The historic fund is one of the largest philanthropic funds of any kind focused on community-based nonprofits that serve District residents. Given that 80 percent of DC’s health outcomes are driven by social, economic, and other factors, compared to just 20 percent by clinical care, the Health Equity Fund adopts an economic mobility framework to address the root causes of health inequity and advances a sustainable network of people, organizations, and projects to ensure equitable health outcomes for Black, Brown, Indigenous, People of Color and other marginalized populations in DC.
We are especially grateful to the Health Equity Fund for the support and shared vision of health equity and racial and economic justice.