New study indicates medical debt associated with worse health status, underscoring importance of legislative proposal in New York to alleviate financial burden of disease

By American Cancer Society Cancer Action Network | March 4, 2024

Patient advocates & public health leaders rally around legislative effort to alleviate medical debt in New York

ALBANY, NY – March 4, 2024 – As state lawmakers consider proposals that aim to reduce the financial impact of disease on patients and families, a new study from the American Cancer Society (ACS) shows that medical debt is associated with worse health status, more premature deaths and higher mortality rates.

Researchers with the ACS have found that medical debt was associated with more days of poor physical and mental health, more years of life lost and higher mortality rates for all-cause and leading causes of death at the county level in the United States. The study is published today in the Journal of the American Medical Association (JAMA) Network Open. 

The results showed, on average, 19.8% of the population in a county had medical debt in collections. After adjusting for county-level sociodemographic characteristics, one percentage point increase in population with medical debt was associated with 18.3 physically unhealthy days and 17.9 mentally unhealthy days per 1000 people during the past month; 1.12 years of life lost per 1,000 people; and 7.51 per 100,000 person-years in age-adjusted all-cause mortality rate. Associations of medical debt and elevated mortality rates were consistent for all leading causes of death, such as cancer, heart disease and suicide.

In her provisional 2024-25 Executive Budget, Governor Hochul outlined a proposal to alleviate the burden of medical debt by reforming the State Hospital Financial Assistance Law. State legislators have also introduced legislation to address this critical issue.

“The latest ACS study underscores the potential of the Legislature’s and Governor’s medical debt proposals to make a positive impact in New York,” said Michael Davoli, Senior Government Relations Director for American Cancer Society Cancer Action Network (ACS CAN) in New York. “Medical debt is bad for patients’ health, and is the leading policy priority for cancer patients and survivors.  Now, it’s time for legislators to show up for their constituents with cancer.  Both the Legislature and the Governor have proposed important measures to alleviate medical debt.  We must now make sure they are included in the final state budget.”

Assemblywoman Amy Paulin, Chairperson of the Assembly Health Committee and sponsor of the medical debt legislation, said, “I thank the American Cancer Society for studying the health impact aspect of medical debt and bringing it to light. This study shows us that medical debt is not only bad for people’s wallets, it’s also bad for their health. We cannot continue to make the lives of those with medical debt even more difficult than they are already are.”

“The study by the American Cancer Society illuminates the ongoing negative impact that medical debt has on patients’ health and overall lives,” said Senator Gustavo Rivera, Chairperson of the Senate Health Committee, and sponsor of the medical debt legislation. Senator Rivera championed a bill last session that has since become law to prohibit the reporting of an individual’s medical debt to credit agencies.  “We have enacted significant legislative measures in our efforts to eradicate the obscene practice in New York, but we must do more. Our final budget must include reform of the State Hospital Financial Assistance Law proposed by Governor Hochul, and we can go even further with my #EndMedicalDebt bill package.”

“These deeply upsetting new findings from the American Cancer Society that document the impact on patients’ morbidity and mortality underscore the urgent need to adopt the proposals offered by Governor Hochul and State Legislative leaders to reform our broken Hospital Financial Assistance Law (HFAL) and to permanently halt the practice of the State-run hospitals suing low-income patients and patients of color,” said Community Service Society of New York Vice President Elisabeth Benjamin. “Over 80,000 New Yorkers have been sued by New York’s nonprofit and government-run hospitals: Passage of the `Ounce of Prevention Act’ (S.1366B|A.6027) and the “Stop SUNY Suing Act” (A8170|S7778), sponsored by State Senator Gustavo Rivera and Assemblymember Amy Paulin, would modernize the state’s outdated HFAL and terminate the hospitals’ practice of suing predominately low-income patients and patients of color.  Our leaders must act now in the State budget-making process to mitigate the devastating impact of medical debt and make the state’s healthcare system a model for the nation.”

Cancer advocates across the state, like lung cancer survivor Colette Smith, met with dozens of lawmakers this week to advocate for the Legislature to adopt and improve upon Governor Hochul’s proposed FY25 budget medical debt provisions. Advocate are calling for legislators to reform the State Hospital Financial Assistance Law by incorporating additional protections outlined in the Ounce of Prevention Act (S1366B/A6027A) and the Stop SUNY Suing Act (A8170/S7778) in the one-house budget proposals.

“Like many others, I faced significant medical bills because of my cancer diagnosis. Patients should have access to the financial assistance they are eligible for so they can focus on their care and recovery without having to choose between lifesaving treatment and basic needs and without fearing debt collectors,” said Smith. “Patients already must deal with managing their disease. That’s stressful enough. They shouldn’t have to worry about being the target of predatory debt collection practices. The only thing they should be focused on is managing their condition.”



The American Cancer Society Cancer Action Network (ACS CAN) advocates for evidence-based public policies to reduce the cancer burden for everyone. We engage our volunteers across the country to make their voices heard by policymakers at every level of government. We believe everyone should have a fair and just opportunity to prevent, detect, treat, and survive cancer. Since 2001, as the American Cancer Society’s nonprofit, nonpartisan advocacy affiliate, ACS CAN has successfully advocated for billions of dollars in cancer research funding, expanded access to quality affordable health care, and advanced proven tobacco control measures. We stand with our volunteers, working to make cancer a top priority for policymakers in cities, states and our nation’s capital. Join the fight by visiting