Fact checked by Shannon Sparks
When chest pains sent 30-year-old Kaylee Ament of Sandwich, Illinois, to the emergency room, she expected care, not financial turmoil. Four hours of blood work, an EKG, and what doctors ultimately determined was heartburn left her with a bill she never anticipated.
“I just didn’t think about it,” Ament says. The working mother of four had been experiencing chest pains for hours. “Heart issues run in my family, so I just went for help,” she says.
Her experience reflects a national burden that millions of families face. More than one-third of households in the United States carry some medical debt, and roughly 21% have past-due bills, according to the journal Health Affairs Scholar. Some 23% are paying bills on a payment plan, and 17% borrowed or still owe loans to cover healthcare costs. Medical debt now ranks among the most common forms of household credit after mortgages, credit cards, and auto loans.
Medical debt has become a defining feature of the U.S. healthcare system, cutting across all income levels but hitting lower-income households hardest. Americans carry an estimated $220 billion in medical debt, according to the American Hospital Association.
In Illinois, Senate Bill 2933 has reshaped the landscape. Since January 2025, medical debt no longer appears on credit reports. However, uncertainty remains about whether federal law could override the Illinois law. In October 2025, the Consumer Financial Protection Bureau said the federal Fair Credit Reporting Act may not allow states to ban medical debt from credit reports. That alone does not change Illinois law; the federal government would have to take the state to court.
Meanwhile, Illinois’ Medical Debt Relief Program has erased nearly half a billion dollars in balances, helping hundreds of thousands of residents.
Policy changes, however, do little to ease the shock people face when bills arrive, particularly for those already living on tight margins.
“Low-income patients are impacted first and foremost,” says Thomasina Wilkins, chief revenue officer at Sinai Chicago, the largest private safety-net provider in Illinois. Many people don’t have comprehensive insurance, or they face high out-of-pocket costs, forcing difficult trade-offs among housing, food, and medication.
Sinai works to ease that burden early, Wilkins says. Care coordinators screen people at intake for financial need and connect them with social services, Medicaid applications, and charity care.
Communication is critical, Wilkins adds. “Call your patient financial services department, share your challenges, and ask for education,” she says.
Hospitals often offer pay-off discounts, interest-free payment plans, and charity care to help qualifying patients reduce medical debt. The National Patient Advocate Foundation also recommends reviewing bills carefully, requesting itemized statements, and contacting billing departments early to ask about discounts or financial assistance.
Wilkins says the worst mistake is ignoring bills or avoiding contact altogether.
When necessary, hospitals may allow monthly, interest-free repayment plans. Negotiating directly with collectors can sometimes reduce balances, as Ament did when she settled her emergency room bill for less than the original amount.
But the debt took a toll. “When I saw that number, I was like, ‘Oh, my God. I don’t have that kind of money,’” she says. Her advice: Weigh your options when possible before incurring large bills, and treat financial planning as part of healthcare.
In Illinois, medical debt may no longer affect credit scores, but the cost of illness still reverberates through people’s budgets.
Originally published in the Spring/Summer 2026 print issue.
Catherine Gianaro, a freelance writer and editor based in Chicago, has written about healthcare and higher education for more than three decades. With 90-plus awards in communications, she is well-versed in storytelling.
