Minnesota passed one of the strongest medical debt protection laws in the country. The Debt Fairness Act, signed by Governor Walz on June 17, 2024, took effect in stages starting October 1, 2024, with additional garnishment reforms kicking in April 1, 2025. As of 2026, Minnesota residents have legal protections against spousal liability, credit bureau reporting of medical bills, denial of care, and runaway wage garnishment.
Quick Answer: The Minnesota Debt Fairness Act (2024) prohibits automatic transfer of medical debt to a spouse, bans hospitals from reporting medical debt to credit bureaus, bars denial of medically necessary care over unpaid bills, and caps wage garnishment for medical debt at 10% to 25% based on income. Workers earning below 40 times the state minimum wage weekly are fully exempt from garnishment.
If you have a hospital bill you cannot read or trust, the CoveredUSA Bill Analyzer can compare each line item against standard Medicare rates to identify overcharges, billing errors, and charity care eligibility before you pay a dollar or engage a collector.
What the Debt Fairness Act Actually Changed
Before this law, Minnesota had a quirk that most people did not know about: medical debt was one of the few debt categories where the state's marriage law automatically created spousal liability. If your spouse racked up $40,000 in hospital bills and died, that debt could land on you. That exception is now gone.
Here is what changed across each effective date:
October 1, 2024:
- No automatic transfer of medical debt to a spouse (at death or during life)
- Hospitals and clinics cannot report medical debt to credit reporting agencies
- Providers cannot deny medically necessary care to a patient with unpaid balances
- Debt collectors cannot use robo-dialers, threaten service withholding, or contact third parties about medical debt
- Collectors must notify patients of their right to legal representation
April 1, 2025 (and forward into 2026):
- Income-based wage garnishment caps replace the old flat 25% rule
- Workers below the minimum wage threshold are completely exempt from garnishment
Minnesota Wage Garnishment Tiers (2026)
The old rule was simple and harsh: creditors could garnish up to 25% of your disposable earnings, period. The Debt Fairness Act replaced that with a tiered system tied to Minnesota's minimum wage. As of 2026, the state minimum wage is $11.41 per hour (effective January 1, 2026).
Disposable earnings means your pay after legally required deductions (federal and state taxes, Social Security, Medicare) but before voluntary deductions like health insurance or 401(k) contributions.
| Weekly Disposable Earnings | Garnishment Cap |
|---|
| Below $456/week (under 40x minimum wage) | Exempt (0%) |
| $456 to $685/week (40x to 60x minimum wage) | 10% |
| $685 to $913/week (60x to 80x minimum wage) | 15% |
| Above $913/week (over 80x minimum wage) | 25% |
The monthly equivalents for reference:
| Monthly Disposable Earnings | Garnishment Cap |
|---|
| Below $1,978/month | Exempt (0%) |
| $1,978 to $2,967/month | 10% |
| $2,967 to $3,955/month | 15% |
| Above $3,955/month | 25% |
If you earn close to Minnesota's minimum wage, the law likely protects most or all of your paycheck from a hospital debt garnishment.
The Spousal Liability Change: Why It Matters
Before the Debt Fairness Act, Minnesota's family law included a carve-out that made spouses liable for "necessaries," which courts interpreted to include medical care. This was not unique to Minnesota, but most states had already repealed similar doctrines. Minnesota held onto it longer.
The practical result: a surviving spouse could be sued for a deceased partner's unpaid hospital bills even if the debt was entirely in the deceased spouse's name. It was also possible for a hospital to go after a living spouse's wages or bank accounts for the other spouse's treatment costs.
As of October 1, 2024, neither scenario is legal in Minnesota. Medical debt stays with the patient it was incurred for. Period.
This protection applies to bills incurred at any licensed healthcare provider operating in Minnesota, including hospitals, clinics, urgent care centers, and specialty practices.
Charity Care: What Hospitals Must Do Before Collecting
Minnesota law (Minn. Stat. Sec. 144.587 and 144.588) requires hospitals to screen patients for charity care eligibility before taking collection action. Before a hospital can file suit, garnish wages, or refer a debt to a third-party collector, it must file an affidavit of expert review certifying all of the following:
- The hospital complied with its financial assistance screening requirements
- There is a reasonable basis to believe the patient owes the debt
- All known insurance carriers and third-party payors were properly billed first
- The patient was given a reasonable opportunity to apply for charity care if circumstances suggested eligibility
- If the patient indicated inability to pay the full amount, the hospital addressed that appropriately
If the hospital fails to file this affidavit, a court must dismiss the collection action with prejudice. That is a hard stop, not a slap on the wrist.
The charity care thresholds vary by hospital in Minnesota. Some large systems use 200% of the federal poverty level (FPL) as the cutoff for free care. Others go as high as 300% FPL. The Star Tribune found that Minnesota hospitals apply at least 11 different income thresholds, and many require financial disclosure beyond just income, including bank accounts, retirement funds, and property values.
2026 Federal Poverty Level reference (used by most charity care programs):
| Household Size | 100% FPL | 200% FPL | 300% FPL |
|---|
| 1 | $15,960 | $31,920 | $47,880 |
| 2 | $21,640 | $43,280 | $64,920 |
| 3 | $27,320 | $54,640 | $81,960 |
| 4 | $33,000 | $66,000 | $99,000 |
| 5 | $38,680 | $77,360 | $116,040 |
| 6 | $44,360 | $88,720 | $133,080 |
| 7 | $50,040 | $100,080 | $150,120 |
| 8 | $55,720 | $111,440 | $167,160 |
Even if your income falls above these thresholds, hospitals in Minnesota are still required to make payment plans available and cannot use aggressive collection tactics like garnishment without first completing the charity care screening process.
Medical Debt and Your Credit Score in Minnesota
Hospitals and medical providers in Minnesota are now banned from reporting unpaid medical bills to Equifax, TransUnion, or Experian. If you have a medical collection account that appeared on your credit report after October 1, 2024, that is a potential violation of the Debt Fairness Act, and you can contact the Minnesota Attorney General's office.
Note: the ban applies to providers themselves. Third-party debt collectors who purchased old medical debt before the law took effect may still appear on credit reports in some cases. If you are seeing medical collections on your report and are unsure whether they are covered under the new law, a consumer law attorney can advise you for free under many legal aid programs in Minnesota.
Mid-Minnesota Legal Aid and Southern Minnesota Regional Legal Services both offer help to income-eligible residents dealing with medical debt collection issues.
What To Do If a Collector Contacts You About Medical Debt
If a debt collector calls about a Minnesota hospital or clinic bill, you have several rights under the Debt Fairness Act that stack on top of federal protections under the Fair Debt Collection Practices Act:
- Request written verification. The collector must provide proof of the debt before continuing collection activity.
- Ask for charity care status. If the original hospital did not screen you for charity care, the collection attempt may be invalid.
- Check the garnishment math. If a garnishment order has been issued against you, compare your weekly disposable income to the tier table above. Anything above the legal cap is a violation.
- Contact the AG. The Minnesota Attorney General's office has a consumer protection division that handles Debt Fairness Act violations. Call 651-296-3353 or visit ag.state.mn.us.
- Get the bill analyzed before paying. Before writing a check on any large medical bill, it is worth knowing whether the charges are accurate. Upload your bill to the free CoveredUSA Bill Analyzer to flag line items that exceed Medicare rates, identify duplicate charges, and see whether you may qualify for charity care or financial assistance programs.
MinnesotaCare and Medical Assistance: Preventing Future Medical Debt
The best way to deal with medical debt is to avoid it. Minnesota has two public coverage programs that cover adults with limited income:
Medical Assistance (Minnesota's Medicaid):
- Covers adults ages 19 to 64 with income up to 138% FPL
- No premium, minimal cost-sharing
- Apply through MNsure at mnsure.org or call 1-855-366-7873
MinnesotaCare:
- Covers adults earning between 138% and 200% FPL who do not have access to affordable employer coverage
- Low monthly premiums based on income
- Also apply through MNsure
2026 Income Limits for Minnesota Public Coverage:
| Household Size | Medical Assistance (138% FPL) | MinnesotaCare (200% FPL) |
|---|
| 1 | $20,814/year | $31,300/year |
| 2 | $28,129/year | $42,300/year |
| 3 | $35,444/year | $53,300/year |
| 4 | $42,759/year | $64,300/year |
| 5 | $50,074/year | $75,300/year |
| 6 | $57,389/year | $86,300/year |
If you are uninsured and have existing medical debt, enrolling in coverage now prevents more debt from piling up on top of what you already owe. Neither Medical Assistance nor MinnesotaCare eliminates prior medical debt, but they do mean your next ER visit, specialist appointment, or prescription is covered.
How to Apply for Help in Minnesota
Step 1: Determine your coverage option.
Compare your annual household income to the table above. If you fall under 138% FPL, you likely qualify for Medical Assistance at no cost. Between 138% and 200% FPL, MinnesotaCare is the target.
Step 2: Gather documents.
You will need proof of identity, proof of Minnesota residency, Social Security number (if applicable), and recent income documentation (pay stubs, tax return, or a self-employment statement).
Step 3: Apply through MNsure.
Visit mnsure.org, call 1-855-366-7873, or visit your county human services office. Applications for Medical Assistance can be submitted any time of year. MinnesotaCare also has year-round enrollment.
Step 4: Address existing medical debt.
After your coverage is confirmed, contact any hospital with outstanding balances. Request a charity care application retroactively if your income is low. Hospitals cannot deny this request.
Step 5: Dispute any invalid charges.
Upload your bill to the CoveredUSA Bill Analyzer to check line items for errors. Hospital billing errors are common. Knowing your bill is accurate before you negotiate or pay protects you from overpaying.
Frequently Asked Questions
Does the Debt Fairness Act apply to bills from before October 2024?
The law's protections are largely forward-looking. The spousal liability change, the credit reporting ban, and the denial-of-care prohibition apply to conduct after October 1, 2024. If a hospital bills you after that date, those protections apply regardless of when the underlying service happened. Wage garnishment reforms apply to any garnishment action initiated after April 1, 2025.
Can a Minnesota hospital still sue me for an unpaid medical bill?
Yes, hospitals can still pursue collection through the courts. What they cannot do is skip the charity care screening step, report the debt to credit bureaus while the case is pending, or garnish more than the income-tier cap allows. They must file the affidavit of expert review with any lawsuit or it gets dismissed.
I received a garnishment order from a hospital. Can I fight it?
You can challenge the garnishment if your income falls below the exemption threshold (under 40 times the state minimum wage per week), or if the garnishment percentage exceeds what the tier table allows for your income level. File an objection with the court that issued the order and bring documentation of your weekly earnings. Legal aid can help if you cannot afford an attorney.
Does the Debt Fairness Act cover dental or mental health bills?
The credit reporting ban and the denial-of-care protections cover medical debt broadly, which Minnesota law defines to include bills for "services provided by a health care provider." Dental, mental health, and substance use disorder services from licensed providers fall within this definition. The spousal liability change applies to the same category.
My credit report shows a medical collection from a Minnesota hospital. What can I do?
If the collection was reported after October 1, 2024, file a dispute with the credit bureau and contact the Minnesota Attorney General. Note that a separate federal CFPB rule that would have removed most medical debt from credit reports nationwide was vacated by a federal court in July 2025, so federal protections are limited. Minnesota's state-level ban still applies to providers reporting debt after October 1, 2024. Dispute the item with the bureau and include documentation showing it is medical debt.
How do I find out if I qualify for charity care at my specific hospital?
Ask the hospital's billing department directly for a financial assistance application. By law, Minnesota hospitals must provide this upon request. Bring or submit documentation of your monthly household income and family size. If the hospital denies the application without a clear income-based explanation, contact the Minnesota Department of Health.
What is the CoveredUSA Bill Analyzer and how does it help with medical debt?
The CoveredUSA Bill Analyzer is a free tool that takes a photo or upload of your hospital bill and compares each charge to Medicare reimbursement rates and standard benchmarks. It flags items that appear inflated, identifies duplicate billing codes, and notes whether your income level may qualify for charity care at the billing institution. It does not provide legal advice, but it gives you a factual baseline before you negotiate, dispute, or pay any amount. Upload your hospital bill to the free CoveredUSA Bill Analyzer to find errors, overcharges, and charity care options in 30 seconds.
Will the Debt Fairness Act protect me if I owe a national hospital chain operating in Minnesota?
Yes. The law applies to any healthcare provider licensed to operate in Minnesota, regardless of whether the parent company is based in another state. If the bill originates from a Minnesota facility, Minnesota law governs the collection process.
