Health Law Advocates, Inc.
30 Winter Street, Suite 1004
Boston, MA 02108

Ph: 617-338-5241
Fax: 617-338-5242

Priority Areas

Medical Debt Initiative


HLA has a long history of advocating for low-income Massachusetts residents with unaffordable medical bills and is the leading provider of pro bono legal services to vulnerable consumers with medical debt in the Commonwealth.  Since our founding 16 years ago, HLA attorneys have represented and advised clients who faced a financial catastrophe simply because they needed health care.  Medical debt is a leading cause of financial hardship for people across the country and Massachusetts is no different.  Furthermore, not only does medical debt have a major impact on personal finances, it is a significant barrier to health care.  


Statistics on the prevalence and devastating results of medical debt are striking.  A 2009 Urban Institute report found that in every Massachusetts County at least 16.4% of adults age 18-64 had problems paying medical bills in the last 12 months.  Health Affairs published a study in February 2011 which found that 23% of Massachusetts residents in fair or poor health and 17% of low-income residents had unmet medical care needs due to cost.  A March 2011 study in the American Journal of Medicine found that medical bills contributed to 53% of Massachusetts bankruptcies in 2009.  These findings demonstrate that despite the wonderful gains we have made in Massachusetts to increase our rate of insurance, health care consumers still experience serious financial problems and barriers to health care because of medical bills.


In 2011, HLA aggressively and successfully fought to help individual low-income consumers avoid and cope with medical debt.  HLA represented 234 low-income clients with outstanding unaffordable medical debt in 2011 and relieved them of more than $273,000 in medical debt.  HLA lawyers protected clients from improper provider billing practices, gained insurance coverage for care our clients had been billed for and negotiated complete or partial medical debt waivers with providers.  HLA attorneys were also careful to work to clear clients’ credit reports to help them avoid debilitating bad credit scores.


An Act Preventing Unnecessary Medical Debt

Not only did HLA lead Massachusetts in providing pro bono legal representation to low-income consumers with medical debt in 2011, but we were leaders in advocating for public policy reforms to reduce the tremendous burden of medical debt on those we serve.  HLA and members of our Medical Debt Task Force authored legislation entitled An Act Preventing Unnecessary Medical Debt in collaboration with State Representative Jeffrey Sanchez who chairs the Massachusetts Legislature’s Public Health Committee introduced the proposal in January 2011.  The bill prevents medical debt by facilitating hospital patients’ participation in financial assistance programs, reducing gaps in insurance enrollment for low-income consumers and preventing unfair medical debt collection tactics.  HLA’s Medical Debt Task Force includes Health Care For All, Community Catalyst, The Access Project, Greater Boston Legal Services, The Volunteer Lawyers Project, The National Consumer Law Center, Shelter Legal Services and Costs of Care. 


The Affordable Care Act (ACA) signed into law by President Obama in 2006 includes provisions specifically designed to reduce medical debt among hospital patients and in 2011 HLA actively pushed for their aggressive implementation.  We joined with advocates nationwide in petitioning the U.S. Treasury Secretary to issue regulations strongly enforcing aspects of the ACA that require tax-exempt hospitals to maintain robust and well-publicized charity care policies, limit charges for uninsured patients and fair collection practices.