What the law does
Washington, D.C., has a new medical debt law. The Medical Debt Mitigation Amendment Act of 2026, D.C. Law 26-172, became effective on August 20, 2026, after Mayor Muriel Bowser returned it unsigned. [1][2]
The law bars health care providers and debt collectors from reporting medical debt to consumer reporting agencies. They cannot begin collecting until 180 days after a patient receives the first bill and must give at least 90 days’ notice first. Interest on medical debt is capped at 3% a year. [1]
Providers and collectors may not place a lien on a patient’s primary home, and they may not garnish wages from households earning less than 500% of the federal poverty level. [1]
Hospitals and other covered facilities must offer free care to patients with household incomes at or below 200% of the poverty level and discounts of 75%, 60% or 40% for incomes up to 300%, 400% and 500% of it. Payment plans must be offered with monthly installments of no more than 3% of household income, though a higher installment is allowed if the patient asks in writing or already has a plan with a higher percentage in the same health system. [1]
The law also limits how providers can offer medical credit cards and loans. They cannot help patients fill out applications, promote these products to patients who are sedated or in treatment areas, or charge them before a procedure. [1]
When it applies
Becoming law and applying are not the same here. Section 6 says the act applies six months after its cost is included in an approved budget and financial plan, as certified by the District’s chief financial officer. [1]
A September 10 law firm analysis said the District’s fiscal 2027 Budget Support Emergency Act repeals that funding delay beginning October 1, 2026. That change could not be confirmed against enacted text, so the date the rules begin to apply remains unsettled. [2]
The credit reporting ban may also face a legal challenge. In an October 2025 interpretive rule, the Consumer Financial Protection Bureau said the federal Fair Credit Reporting Act generally preempts state laws touching broad areas of credit reporting. The bureau has acknowledged the rule is not legally binding, and courts have split on the question. [3][4]
What remains uncertain
The applicability date depends on budget legislation and a chief financial officer certification that could not be confirmed from enacted text; until then, the protections may not yet be enforceable. Whether the credit reporting ban survives a federal preemption challenge is an open legal question. Summaries of the law here are simplified and not legal advice.
Sources
- D.C. Law Library — D.C. Law 26-172, Medical Debt Mitigation Amendment Act of 2026 ↗Official source
- Sheppard Mullin — D.C. enacts broad medical debt protections, September 10, 2026 ↗Source
- Federal Register — Consumer Financial Protection Bureau, Fair Credit Reporting Act; Preemption of State Laws, October 28, 2025 ↗Official source
- National Consumer Law Center — The latest on keeping medical debt out of credit reports ↗Source