Ohio – Healthcare affordability has emerged as one of the biggest issues in Ohio’s governor race, and Democratic candidate Amy Acton is placing medical debt relief at the center of her campaign as she tries to win over voters ahead of November.
Acton, a physician and former state public health director, says she wants Ohio to follow the path taken by several Democratic-led states that have dramatically reduced medical debt by purchasing and eliminating unpaid balances for qualifying residents. Her proposal is becoming one of the most talked-about parts of her campaign as she prepares to face Republican businessman Vivek Ramaswamy in a high-profile contest for the governor’s office.
The former health official has spent much of her campaign emphasizing healthcare issues, an area where she believes many Ohio families are struggling regardless of their political affiliation.
During a local interview earlier this month, Acton pointed to a family she recently met whose newborn twins required extended care in a neonatal intensive care unit, leaving them with hundreds of thousands of dollars in medical bills.
“Every one of us is one healthcare emergency away from losing everything,” Acton said.
That message has become a central theme of her campaign as she argues that unexpected illnesses and medical emergencies can quickly push working families into financial crisis.
A plan modeled after other states
Acton’s proposal would target medical debt held by lower-income Ohioans and families facing unusually large healthcare burdens.
According to details she discussed with local media, the plan would use a one-time payment system to buy and eliminate qualifying medical debt.
Eligibility would be based on income and financial hardship. Under the framework she outlined, debt relief would be available to Ohioans earning at or below 400% of the federal poverty level. For a family of four, that would equal approximately $128,600 annually.
Families whose medical debt exceeds 5% of their household income could also qualify.
While many details remain unresolved, Acton has repeatedly pointed to Illinois as a model.
Illinois Governor JB Pritzker’s administration spent roughly $10 million to eliminate as much as $1 billion in medical debt. Acton has expressed interest in adapting a similar approach in Ohio and has embraced income thresholds that mirror those used in Illinois.
Other states, including Michigan and New Jersey, have pursued comparable programs. Those efforts often involved partnerships with the nonprofit organization Undue Medical Debt, which helps acquire and retire debts that hospitals and healthcare providers have little chance of collecting.
Supporters of such programs argue that medical debt can often be purchased for a small fraction of its face value, allowing governments to erase large amounts of debt at a relatively low cost.
Medical debt remains a major issue
Acton’s proposal comes as healthcare costs continue to dominate public concerns across the country.
Research cited by health policy groups suggests that roughly one in seven Ohio residents had medical debt that remained unpaid for at least 90 days in 2022.
Nationally, the problem is even larger.
According to research published by health policy organization KFF in 2024, Americans collectively owe about $220 billion in medical debt. The organization also found that nearly six out of ten Americans have either carried medical debt within the past five years or are currently dealing with it.
The true scope of the issue may be difficult to measure precisely because major credit reporting agencies stopped including many smaller medical debts in credit reports beginning in 2023. Consumer Financial Protection Bureau data previously showed that most medical collections involved balances under $500.
Acton argues those statistics demonstrate why aggressive action is necessary.
Building on efforts already seen in Ohio
Ohio cities have already experimented with similar debt-relief efforts.
Toledo eliminated more than $230 million in medical debt using approximately $1.6 million in federal pandemic relief funds. Cleveland launched a comparable initiative, spending $1.9 million to erase roughly $181 million in medical debt.
Those examples have become important talking points for supporters who argue that debt relief programs can generate significant results without requiring enormous taxpayer spending.
Acton’s proposal also builds upon bipartisan healthcare legislation introduced in the Ohio House last year by Democratic Representative Michele Grim and Republican Representative Jean Schmidt.
That legislation sought to cap medical debt interest rates at 3%, prevent healthcare providers from reporting medical debt to credit agencies, and stop wage garnishment tied to medical debt collection efforts.
Broader healthcare agenda
Medical debt forgiveness is only one piece of Acton’s larger healthcare platform.
She has also proposed creating “Ohio Rx,” a state-based prescription drug price tool modeled after TrumpRx.gov.
“As governor, I will launch Ohio Rx, an online platform that will leverage Ohio’s purchasing power from its Medicaid single pharmacy benefit manager to drive down prescription drug prices for all Ohioans,” Acton’s website reads.
In addition, she wants legislation requiring health insurers to count out-of-pocket medication and medical supply expenses toward policy deductibles, a move she argues would make healthcare coverage more useful and affordable.
Throughout the campaign, Acton has framed these ideas as practical solutions rather than partisan proposals.
“Everyday Ohioans, 95% of Ohioans, don’t care what party you are,” Acton said. “They want you working on great, affordable health care; they want housing, rent that’s affordable; they want great schools and workforce training; they want a great path for a job; they want to live in a place with a high quality of life.”
As the governor’s race continues, her effort to make medical debt relief a major campaign issue could become one of the clearest contrasts between her vision for Ohio and that of her Republican opponent.
