Medical Billing Protections by State (2026)
How well does your state protect you from surprise bills, unaffordable hospital charges, and aggressive debt collection?
Top-ranked states
California and Washington offer the strongest patient protections — free charity care to 350–400% FPL, landmark surprise billing laws, and strong debt collection limits.
States without Medicaid expansion
Alabama, Florida, Georgia, Kansas, Mississippi, Tennessee, Wyoming, and (until recently) South Carolina left millions uninsured and exposed to catastrophic medical debt.
Wage garnishment banned
North Carolina and Pennsylvania prohibit wage garnishment for consumer medical debt — a powerful protection most states don't offer.
Most generous charity care
Illinois requires hospitals to provide free or reduced care up to 600% of the federal poverty level — the most generous charity care law in the nation.
Know your rights. Fight your bill.
BillKarma analyzes your hospital bill, identifies overcharges, and helps you dispute or negotiate — for free.
Check My Bill NowEach state is scored on a 100-point scale across five dimensions: Medicaid expansion (20 pts), surprise billing protections (25 pts — state law vs. federal-only), charity care mandate (25 pts — % FPL threshold required by law), statute of limitations (15 pts — longer SOL = more consumer protection), and wage garnishment limits (15 pts — lower cap = stronger protection). Data reflects laws in effect as of April 2026.
Sources: State statutes, Kaiser Family Foundation, National Consumer Law Center, CMS, Hospital Price Transparency data. General information only — not legal advice. Consult a consumer attorney for your specific situation.