On August 20, the District of Columbia’s Medical Debt Mitigation Amendment Act of 2026 (B26-0438) became law without the Mayor’s signature after the D.C. Council passed the bill unanimously. In relevant part, the law prohibits health care providers and debt collectors from reporting medical debt to consumer reporting agencies, filing a property lien against a patient’s primary residence, and garnishing wages for patients with a household income below 500 percent of the federal poverty level. The law caps interest on medical debt at 3 percent annually and prohibits medical debt collection until 180 days after the date the consumer receives the first posted medical bill, with at least 90 days’ notice required before collection begins. The law also restricts health care providers from assisting patients in completing applications for medical lending products, promoting such products to patients under sedation or in treatment areas, or requiring credit card pre-authorization before emergency health services are provided.

The law also requires health care facilities to establish financial assistance policies and affirmatively screen patients for eligibility, with payment plans for eligible patients capped at 3 percent of monthly household income. Any medical debt sold to a collection entity must retain the patient’s payment plan terms, and hospital liens on injury recoveries are capped at 33 percent of the award. The law’s operative requirements do not take effect until six months after D.C. includes its fiscal effect in an approved budget and financial plan.