Medical debt relief programs, and how they really work

What kinds of programs exist?

Only hospital financial assistance takes applications from patients. The others choose the debts themselves.

How debt-purchase programs work

Unpaid medical bills are often sold in bulk. A relief charity or a government program buys a group of these debts and cancels them instead of collecting.

People whose debts are cancelled are usually told by mail. If you get such a letter, keep it as proof.

Government programs

A tracker of these programs follows the state and local governments taking part. The public money they committed is in the key facts above. The medical debt they report cancelled so far is more than $13.50 billion (The New School Budget Equity Project, Medical Debt Elimination Policy Tracker, As of April 29, 2026) Totals mix programs of very different design.

Many of these programs were paid for with federal pandemic recovery money, which has a spending deadline Source 22. Don't count on new programs from that money.

Two examples

• North Carolina. Through a Medicaid payment incentive, every eligible acute care hospital in the state adopted medical debt policies. Hospitals relieved medical debt in the program's first year Source 33. The key facts above give the total.
• Cook County, Illinois. The county's program covers two groups of residents. The first has income at or under a set share of the federal poverty guidelines. That share is 400% (Cook County ARPA, Medical Debt Relief Initiative, 2026). The second has medical debt at or above a set share of household income. That share is 5% (Cook County ARPA, Medical Debt Relief Initiative, 2026). There is no application: the county and a relief charity send letters to the people whose debt is cancelled.

Which states and counties have run one?

These are the state and county programs whose own government pages we have read. Nobody applies to any of them: each program chooses the debts it can reach, and people whose debt is cancelled are told by letter. Most set limits on income, or on medical debt compared with income. Each program's page gives its rules and any totals it reports; the totals mix programs of very different design, so we don't add them up.

We checked every row on the government's own page on the date shown in the sources. A program that is in effect may still have spent its money, so a new letter is never guaranteed.

Who these programs reach

Each program sets its own rules. Cook County's look at income, and at medical debt compared with income. They can only cancel debts they are able to buy or that hospitals agree to cancel, so they cannot promise to reach any one person.

What you can ask for yourself

You can't sign up for most of these programs, but you can act on your own bill today:

1. Ask the hospital for financial assistance. Every nonprofit hospital must have a policy for emergency and medically necessary care Source 55. Our guide to charity care explains how to apply.
2. Check your state's rules. Some states require hospitals to help people up to a set income. Our charity care guide gives two examples, California and Washington.
3. Look at other help. Our list of organizations that help pay medical bills covers patient funds and free advice.

Be careful with offers to cancel your debt

Government programs and relief charities don't charge you to cancel a debt. Be wary of anyone who asks for a fee, card numbers or bank details to "release" relief. If a letter says it is from The Medical Bill, you can check it here.