A comprehensive framework can distinguish genuine hardship, billing disputes, unaffordable balances, and intentional nonpayment rather than treating every account alike.

Patients need an independent appeal before wage garnishment, liens, or lawsuits because billing systems and coverage decisions frequently contain errors.

Hospitals already possess billing and insurance information that can identify many likely eligible patients without requiring another complicated application.

Collection should pause until the provider documents an accurate bill, insurance processing, plain-language notice, and a completed assistance determination.

The state should make prices understandable before treatment instead of layering new restrictions onto legitimate debts after services are delivered.

Medical treatment is often unavoidable, and families should not lose housing, wages, or credit because they became sick.