Oklahoma lawmakers on both sides of the aisle are working to lessen the impact of medical debt on their constituents.
They are advocating for increased state regulations to protect people that have incurred medical debt and to ensure greater pricing transparency from hospitals in the state ahead of medical procedures.
Over a third of U.S. adults face debt from medical or dental bills. The debt is one of the leading causes of bankruptcy in the country, according to a report from the Commonwealth Fund, a private foundation supporting independent health care research. The report found that medical debt greatly affects both insured and uninsured individuals and the fear of incurring debt often deters Americans from seeking care.
Oklahoma Senate Bill 889 requires hospitals to make the cost of their “most usable” services transparent to patients so they’re aware of the cost, said Sen. Casey Murdock, R-Felt, the bill author.
The measure was signed by Gov. Kevin Stitt and will be in effect Nov. 1.
“If this is implemented across the United States, it could save billions of dollars in health care costs,” Murdock said.
The new law has “teeth” because providers could face penalties for noncompliance, and hospitals will be more inclined to comply with transparency rules if there’s potential financial impact, Murdock said.
Oklahoma’s State Department of Health is charged with overseeing compliance.
The agency is “actively preparing,” said agency spokesperson Erica Rankin. There are no anticipated additional costs for implementing the law, she said, and while details are not finalized, the department is confident it will be fully compliant.
In a similar effort, House Bill 4148, authored by Rep. Suzanne Schreiber, D-Tulsa, and signed into law in 2024, requires debt collectors to submit evidence of a hospital’s compliance with price transparency rules before filing to collect on medical debts from patients of the institution.
The Oklahoma Hospital Association is supportive of greater price transparency, said Rich Rasmussen, CEO and president of the group, but overburdensome regulations can affect hospital operations.
“We don’t want to be noncompliant with any requirement placed on us, but oftentimes, when a state comes in after the federal government has made a policy decision and decides to do something on their own, it creates that noncompliance,” he said. “And that’s what we want to avoid.”
Rasmussen pointed to data from the Centers for Medicare and Medicaid Services which lists which U.S. hospitals have faced civil monetary penalties for noncompliance with federal price transparency regulations. No Oklahoma hospital has faced a penalty, according to the list.
The Hospital Association has gone beyond what’s required by federal law to standardize reporting, Rasmussen said.
“We began an effort to bring all of our hospitals together on a very broad what we call our community benefit project,” he said. “We have worked together with hospitals all across the state to arrive at, for those who are uninsured or underinsured, what hospitals can do to ensure that if they are eligible for our free or discounted care, that that would be the same measurement that is used across the state.”
Rasmussen said Congress cutting billions in Medicaid dollars will have a domino effect of impacts.
Hospitals may cut services, forcing patients to travel or not receive care at all. Other Oklahomans will be kicked off Medicaid and have to find coverage elsewhere.
“We can’t cut our way out of $6.3 billion of Medicaid reductions,” Rasmussen said.
Rasmussen said he’d like to see greater pricing transparency from insurers, not just providers. Oklahomans with insurance don’t know how much their hospital bills will be and insurers aren’t transparent enough about out-of-pocket costs, he said.
The Commonwealth Fund’s report found that while insured patients are less likely to owe medical debt than the uninsured, about a third of adults insured through employers still incur debt.
Oklahoma lacks medical debt protections in place in other states, including no limits on interest rates, credit reporting, and wage garnishments related to medical debt, according to the report.
Sen. Mary Boren, D-Norman, and Rep. Forrest Bennett, D-Oklahoma City, introduced similar measures during the 2025 session to help minimize the impact of medical debt by prohibiting it from impacting credit scores. Boren and Bennett authored Senate Bill 519 and House Bill 1709, respectively.
Neither bill advanced from its chamber of origin or forgives medical debt. Both lawmakers said they were interested in pursuing the legislation again when they return next session.
“What I found through representing clients, even some young people, is that the credit rating really is a barrier to finding housing,” Boren said. “And because we have so much medical debt, it’s compromising people’s credit rating, and then it creates a housing issue. So what this bill does is prevent reporting by collection agencies to credit reporting agencies medical debt. It doesn’t prevent the collection of the debt. It just prevents the harm to someone’s credit rating.”
Bennett’s bill specifies that for medical debt to not be reported on someone’s credit, it must be incurred from lifesaving or emergency care.
The House lawmaker said his bill was prompted by wanting to codify a Biden era rule into state law.
He said banks were concerned that his bill would prevent them from seeing the “whole picture” behind a consumer before loaning money. Bennett said he’s willing to work with the banking industry on his bill, as long as the integrity of the measure remains intact.
“As much as I like this idea and want to pursue it, we are tinkering around the edges of a major issue,” Bennett said. “And the reality is, we need an overhaul of the health care industry in America and we’re limited at the state level of what we can do.”
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