Struggling with Medical Bills? Here’s Where to Start

The issue is hitting AFT members directly. In a 2026 AFT debt survey, more than 8 in 10 respondents said healthcare costs were contributing to financial stress, while half said they were using credit cards to help cover everyday expenses.

One message came through clearly during the conversation: Patients and families may have more options than they realize when a medical bill becomes difficult to manage.

How Union Members Challenged High Hospital Costs

For Bassler, the issue became personal when she noticed that the cost of her screening mammogram had jumped sharply from one year to the next.

At the time, she was serving as a trustee of her union’s healthcare trust in Monterey County, Calif., where hospital prices had long been a problem for workers. After learning that a change in hospital billing practices was driving up the cost of the mammogram, Bassler went to a hospital board meeting to raise the issue.

The next month, she returned with other union members who shared how the hospital’s prices were affecting their ability to get care. That October, more than 100 workers and supporters filled the boardroom during Breast Cancer Awareness Month. The pressure eventually led to a carve-out for mammograms and biopsies that lowered costs for members.

But the campaign did not end with one procedure. Bassler and other labor leaders later joined unions and community partners to form the Monterey County Health Care Affordability Coalition. Members began regularly traveling to meetings of California’s Office of Health Care Affordability to share stories about high hospital prices, medical debt and the choices workers were being forced to make because of the cost of care.

Those efforts helped bring greater scrutiny to hospital prices in Monterey County and became part of a broader campaign to rein in unusually high healthcare costs.

Bassler’s experience offers a useful reminder for anyone staring at a medical bill that does not make sense: The price on the page is not always the end of the conversation. Sometimes change starts with asking why a service costs what it does and refusing to accept that nothing can be done.

Where to Start When You Can’t Afford a Medical Bill 

For families dealing with a bill right now, Haynes emphasized that the hardest part can simply be figuring out where to begin.

If a hospital bill is difficult to manage, families can start by taking these steps:

1. Check the bill and the hospital website for financial assistance information. One of the first places to look is the bill itself. Hospitals often include information about financial assistance on the statement or on their website.
2. Call the hospital billing office and ask how to apply for financial assistance. Calling the hospital billing office and asking directly about financial assistance, sometimes called charity care, can be an important first step.
3. Ask whether a hospital social worker or community health worker can help. If navigating the process feels overwhelming, Haynes suggested asking whether the hospital has a social worker who can help.
4. Contact a legal aid organization if the billing or collection problem is more complicated. Community health workers may also be able to help patients understand their options, and legal aid organizations can be useful when a billing or collection problem becomes more complicated. Patients should also know that financial assistance is not necessarily limited to people without insurance. High deductibles and other out-of-pocket costs can leave insured families struggling to pay for care, too.
5. Check your state attorney general’s consumer-protection resources. Haynes also recommended checking your state attorney general’s consumer-protection resources when someone is unsure about their rights or where to get help.

Medical Debt Resources for Families and Advocates

The National Consumer Law Center offers several resources for families and advocates trying to navigate medical debt.

• Surviving Debt: NCLC’s free online consumer guide includes an entire chapter on medical debt, along with information on debt collectors, credit reports, collection lawsuits and other financial issues. The 2026 edition includes updated medical-debt guidance.
• An Ounce of Prevention: This report explains how hospital financial assistance policies work across the states and where protections are strong or weak. It can be especially helpful for understanding why some patients qualify for assistance while others may face gaps.
• Health Care Plastic: The Risks of Medical Credit Cards: Medical credit cards can look like an easy way to manage an expensive bill, but they can also turn medical costs into another form of consumer debt. This NCLC resource explains some of the risks associated with credit card usage for medical bills.
• What States Can Do to Help Consumers: Medical Debt: For people interested in broader protections, this issue brief explains steps states can take to strengthen financial assistance, limit harmful collection practices and reduce the impact of medical debt.
• Protecting Older Adults from Surprise Medical Bills: This resource focuses on the billing protections and challenges that can be especially important for older adults, including situations where unexpected charges may arise.
• The Racial Health and Wealth Gap: Impact of Medical Debt on Black Families: This report looks at how medical debt can deepen existing racial inequities in health and household wealth, with a particular focus on Black families.
• Model Medical Debt Protection Act: NCLC’s model law gives advocates and policymakers a framework for stronger state protections, including financial assistance requirements, screening for eligibility and limits on aggressive collection practices.

The AFT also offers medical debt and affordability resources for members, including education tools and medical debt clinics designed to help people understand bills, explore options and get support with more complicated situations. Members looking for more hands-on support can also register for AFT’s medical debt clinic on Sept. 29, 2026.

How Hospital Financial Assistance Can Prevent Medical Debt 

Much of Haynes’ work focuses on what can happen before a medical bill ever reaches collections.

Under federal law, nonprofit hospitals are generally required to have financial assistance policies. However, patients may not know those programs exist, and eligibility rules can vary widely.

NCLC’s Model Medical Debt Protection Act goes further by encouraging states to require hospitals to screen patients for financial assistance rather than waiting for patients to find and apply for it on their own. The model also includes protections aimed at limiting aggressive collection practices and preventing medical debt from causing additional financial harm.

A Medical Bill May Not Be the Final Word

Medical debt can make patients feel as though they have very little room to act, especially when the bill arrives after care has already been provided.

But as the webinar made clear, there are still places to turn for help. A hospital may offer financial assistance; a social worker or legal aid organization may be able to help navigate the process; and a charge that seems fixed may be worth questioning. Sometimes the first step is simply asking what options are available.

A medical bill can be overwhelming, but it does not always have to be the final word. Knowing where to start, who to ask for help, and when to push back can give patients and families more control in a system that often gives them very little.

Watch the Vital Lessons webinar on medical debt and explore AFT’s affordability resources for additional guidance, tools and opportunities for support: