华盛顿特区新法生效：医疗债务不得再上报信用机构
华盛顿特区一项全面改革医疗债务处理方式的新法已经生效：禁止医疗服务提供者和追债公司向信用机构上报医疗债务。据法律媒体 Mondaq 10月12日刊载的 Ballard Spahr 律师事务所分析文章，该法还对追债行为施加了严格限制。
该法在市长穆丽尔·鲍泽未签字的情况下自动生效。鲍泽表示支持其中的医疗债务条款，但反对部分不相关的附加条款。她在致特区议会主席菲尔·门德尔松的信中写道，要求医疗机构为收入在联邦贫困线200%以下的患者提供无限量免费的必要医疗、为500%以下者提供减免费用的规定，“给特区的医疗体系和整体就医可及性带来实质性担忧”，相关要求超过了邻近各州。
除禁止上报信用机构外，新法的主要内容包括：禁止对家庭收入低于联邦贫困线500%的患者扣押工资；禁止对患者主要住所设置财产留置权；首次账单寄出180天内不得追债，且追债开始前须提前90天通知；年利率上限为3%；医疗债务被转卖给追债公司时，患者的还款计划安排必须一并转移；医疗机构必须制定经济援助政策并筛查患者资格。
从全美背景看，拜登政府时期的消费者金融保护局（CFPB）曾支持将医疗债务排除在信用报告之外，但其相关规则被联邦地区法院撤销。据统计，至少已有17个州出台了类似禁令，包括加州、科罗拉多、康涅狄格、伊利诺伊、马里兰、纽约、弗吉尼亚和华盛顿州等。部分州的法律正面临诉讼挑战，而CFPB的一项解释性规则认为此类州法可能被《公平信用报告法》优先适用。
分析指出，特区此次立法走在了全美前列，但后续司法挑战与执行效果仍有待观察。对背负医疗债务的特区居民而言，这无疑是一道重要的保护屏障。
Washington, D.C. Bans Medical Debt From Credit Reports
Washington, D.C. has enacted comprehensive legislation that fundamentally changes how medical debt is handled: health care providers and debt collectors are now prohibited from reporting medical debt to credit reporting agencies. According to an analysis by the law firm Ballard Spahr published on Mondaq on October 12, the law also imposes strict limits on collection practices.
The legislation became law without the signature of Mayor Muriel Bowser, who said she supported the medical debt provisions but opposed some unrelated provisions. In a letter to D.C. Council Chairman Phil Mendelson, Bowser wrote that requirements for health facilities to provide unlimited free medically necessary care for patients up to 200% of the federal poverty level and reduced-cost care up to 500% of the poverty level "creates substantial concerns for the District's health care system and overall access to care," exceeding requirements in neighboring states.
Beyond the credit-reporting ban, the law: prohibits wage garnishment for patients with household incomes below 500% of the federal poverty level; bars property liens against a patient's primary residence; forbids medical debt collection until 180 days after the first bill, with at least 90 days' notice before collection begins; caps interest at 3% annually; requires that payment plan arrangements transfer when medical debt is sold to collectors; and obliges health facilities to adopt financial assistance policies and screen patients for eligibility.
Nationally, the Consumer Financial Protection Bureau under the Biden administration supported banning medical debt from credit reports, but its rule was vacated by a federal district court. At least 17 other states have enacted similar bans, including California, Colorado, Connecticut, Illinois, Maryland, New York, Virginia and Washington. Some of those state laws face court challenges, and a CFPB interpretive rule holds that such laws may be preempted by the Fair Credit Reporting Act.
Analysts say the District's legislation puts it at the forefront nationally, though future legal challenges and enforcement remain to be seen. For D.C. residents carrying medical debt, it is a significant new layer of protection.
图片来源：图：华盛顿特区市政厅约翰·威尔逊大楼正门。摄影：APK，CC BY-SA 4.0，来源：Wikimedia Commons
