Preventing and Reducing Medical Debt in LA County

Medical debt is a critical public health issue in LA County, affecting about one in nine adults. This means that an estimated 881,869 adults were burdened by medical debt in 2023.

The amount of medical debt was estimated to be over $2.9 billion in LA County in 2023.
The percentage of adults burdened by medical debt is similar to those with type 2 diabetes and greater than those with asthma.
Medical debt disproportionately affects families with children, lower-income, Latino, Black, American Indian, and Pacific Islander residents, and people with chronic health conditions.
For many individuals and families, medical debt leads to physical and mental health problems, and financial instability. Even with insurance, healthcare costs can add up quickly and lead to significant debt.
The debt can make it difficult to pay for basics like food and housing and can lead people to skip or delay needed medical care.

To tackle medical debt in LA County, Public Health is working in coalition with a wide range of organizations including non-profits, legal aid groups, health plans, hospitals, physicians and is using a prevention, population-based approach.

Medical Debt in LA County - Baseline Report and Action Plan 2023

In June 2023, Public Health published a Baseline Report and Action Plan on Medical Debt in Los Angeles County showing the scale and impact of the problem, and then updated it in 2024 and 2025. To view all the reports in both English and Spanish, visit the Medical Debt Reports page.

Informed by the baseline report, in October, 2023, the LA County Board of Supervisors approved the motion Reducing Medical Debt in Los Angeles County though improved data collection and innovative strategies to retire Medical Debt. The motion directed several County departments to work together to address this important issue.

Press release: Board Approves Hahn-Mitchell Proposals to Reduce Medical Debt for Local Families

Below are our priority areas and the progress we have made on each.

Collect and Share Data

Tracking Medical Debt Through Data Collection
Our goal is to collect and make public data on healthcare facilities’ debt collection and financial assistance activities to increase transparency for healthcare systems, local government, and community stakeholders, and to track progress.

Los Angeles County Ordinance
In August 2024, the LA County Board of Supervisors approved an ordinance updating Title 11 of the County Code, requiring acute care hospitals to report on their financial assistance operations and debt collection activities to Public Health. The ordinance was adopted in September 2024, with data collection starting in March 2025. It aims to inform policy improvements, identify gaps, and flag missed opportunities, such as patients eligible for assistance being sent to collections.

City of Los Angeles Action
In April 2025, the LA City Council passed a motion directing the City Attorney to draft an ordinance mirroring the County’s requirements, extending data reporting to the 34 acute care hospitals in the City.

Ongoing Surveillance
Public Health’s ongoing surveillance uses data from UCLA’s California Health Interview Survey and helps us to understand the sources of medical debt and its impacts on residents’ lives. For more information and to read our reports, visit the Medical Debt Reports page.

Improve Financial Assistance Programs

Our goal is to help patients fully benefit from existing financial assistance programs by simplifying applications, improving eligibility screening, and expediting qualification to reduce financial burdens.

In September 2025, Public Health released a comprehensive report on hospital financial assistance practices in LA County, alongside recommendations from the Financial Assistance Best Practices Committee. The report highlights trends, identifies areas for improvement, and informs targeted interventions to better protect consumers.

To learn more and to access the financial assistant report and best practices toolkit (including model application and policy) visit the Financial Assistance page.

Relieve Medical Debt

Our goal is to purchase and retire medical debt for low-income LA County residents, reducing financial burdens, improving related health outcomes, and increasing equitable access to care.

Approved by the Board of Supervisors in June 2024, the pilot program launched in December 2024 in partnership with the national nonprofit Undue Medical Debt. As of December 2025, debt relief letters were sent over 171,000 Angelenos, erasing $362 million in medical debt. With additional support from partners, the County aims to relieve $2 billion in medical debt.

To learn more about the debt relief program, visit the Relieve Medical Debt page.

Strengthen Local Coalitions

The Los Angeles Medical Debt Coalition
Public Health leads a multi-sector coalition of over 45 organizations—including consumers, nonprofits, public agencies, policy experts, and healthcare leaders—to address medical debt as a systemic health issue. Using local data, the coalition identifies challenges, develops solutions, and monitors progress across the County.

Summits on Medical Debt
In April 2024, over 100 partners from community, healthcare, and government organizations convened for the first Los Angeles Medical Debt Summit to review data, assess progress, and plan collective action. In October 2025, the coalition reconvened to focus on systems-level solutions, consider local data and strategies and opportunities for collective action. Recent cuts to healthcare and public health heightened the urgency of multi-sector collaboration to protect access to care for Angelenos.

The coalition includes 3 groups working on strategies to reduce and prevent medical debt:

Dental Debt: this group aims to reduce dental debt and increase financial literacy: through tools and training for consumers, communities, and providers; increased transparency and accountability in dental care financing and insurance; and expanded low-cost and no-cost dental care resources.

Consumer Protections and Resources: this group develops and promotes resources for consumers to navigate and prevent medical debt, such as: training for financial coaches, helpline staff, and outreach workers; consumer resources like tip sheets and easy-to-follow guides on rights and protections; and referral resources.

Technology and Financial Assistance: this groups aims to harness technologies to improve financial assistance programs and increase equitable access to healthcare. Projects include: researching presumptive eligibility tools and implementation; and developing a web-based portal to expand access to financial assistance.

Advocate for Policy Changes

LA County and Public Health advocate for policy changes that prevent medical debt, reduce its burden, and promote consumer protection and fair billing practices.

In addition to local initiatives, we advocate for state and federal policy changes to mitigate and reduce the impact of medical debt. Several key policies are already in place to protect consumers from unaffordable medical bills, including regulations to control healthcare costs, payment methods, and collection activities. We continue to track medical debt and fair billing policies that build upon these efforts and provide public comments to strengthen current initiatives.

LA County and Public Health advocacy efforts to date include:

Support for the Patient Medical Debt Prevention Act: CA AB-1312 (enacted on 10/7/25): This law will take effect on 1/1/27 and will require hospitals to proactively screen patients for free or discounted care and apply financial assistance before billing, protecting uninsured, low-income, and homeless patients from medical debt.
Support for the Consumer Debt: Medical Debt bill CA SB-1061 (enacted on 9/24/24): This law, which took effect on 1/1/25, removes medical debt from credit reports and prohibits debt collectors from reporting patients’ medical debt information to credit agencies. According to the California Attorney General in November 2025, SB 1061 is fully in effect. It is illegal for medical debt to appear on credit reports.
Support for the Hospital and Emergency Physician Fair Pricing Policies bill CA AB-2297 (enacted on 9/24/24). This law, which took effect on 1/1/25, clarifies the definitions of charity care and eligibility reviews, bans home liens for eligible patients, allows all cost-sharing deductions, and removes asset considerations.. See fact sheet summarizing the bill.

Acknowledgements
The Department of Public Health gratefully acknowledges the support of The California Endowment, The California Wellness Foundation, and The California Health Care Foundation for their contributions to this initiative.