Illinois Rep. Avelar’s hospital financial assistance reform bill passes House and Senate

Passed bill authored by State Rep. Dagmara Avelar aims to expand and standardize hospital financial assistance and debt collection protections for uninsured patients following approval in both chambers, according to the Illinois General Assembly.

In the House, 73 Democrats voted in favor of the bill, while 34 Republicans opposed it.

Meanwhile, in the Senate, 39 Democrats voted in favor of the bill, while 19 Republicans voted against it.

Avelar introduced the bill in the Illinois House on Feb. 6, 2026 during the 104th session.

The legislation, known as HB5390, was passed on May 20, 2026 during the general assembly session 104.

According to the Illinois General Assembly site, the legislature summarized the bill’s official text as follows: “Amends the Fair Patient Billing Act. Makes changes to findings and defined terms provisions. Provides that a hospital shall not deny any protection or benefit of the Act on the basis of a patient’s citizenship or immigration status or assets or prospective assets. Provides that a patient who inquires about a denial of financial assistance in whole or in part must be permitted to appeal the decision within at least 90 days. Requires a hospital to use only a uniform financial assistance form developed and provided by the Attorney General no later than December 31, 2026. Provides that every hospital bill and every collection notice must notify the patient, in the patient’s preferred language, of the availability of hospital financial assistance and charity care. Establishes further provisions concerning hospitals pursuing collection actions; outsourced health care services; patient responsibilities; and applicability of the Act. Amends the Hospital Uninsured Patient Discount Act. Sets forth provisions concerning uninsured patient discounts for specified income levels. Prohibits hospitals from making the availability of a discount under the Act contingent upon the uninsured patient first applying for coverage under public health insurance programs. Provides that patients may not be denied a discount under the Act on the basis of citizenship or immigration status or assets or prospective assets. Makes other changes concerning uninsured patient discounts, outsourcing health care services, and patient responsibilities. Effective immediately.”

The following is our breakdown, based on the actual bill text, and may include interpretation to clarify its provisions.

In essence, this bill revises the Fair Patient Billing Act and the Hospital Uninsured Patient Discount Act to expand and standardize hospital financial assistance and debt collection protections. It bars denying protections or discounts based on citizenship, immigration status or assets, requires hospitals to screen uninsured patients for aid, and limits payment plans to no more than 4% of monthly household income with remaining balances forgiven after 36 months. It mandates a single statewide financial assistance form by Dec. 31, 2026, guarantees appeal rights for denied aid, extends protections to outsourced on-site providers and large outpatient practices, sets income-based uninsured discount thresholds up to 600% of federal poverty guidelines, caps certain annual out-of-pocket costs, and shortens the time to sue on medical debt to three years. The bill takes effect immediately.

The bill was sponsored by Sen. Mary Edly-Allen (Democrat-31st District), Sen. Mike Simmons (Democrat-7th District), and Sen. Napoleon Harris, III (Democrat-15th District), along with one other sponsor.

Bills in Illinois follow a multi-step legislative process, beginning with introduction in either the House or Senate, followed by committee review, floor debates, and votes in both chambers before reaching the governor for approval or veto. The General Assembly operates on a biennial schedule, and while typically thousands of bills are introduced each session, only a fraction successfully pass through the process to become law.

You can read more about bills and other measures here.

Avelar graduated from Northeastern Illinois University in 2010 with a BS.

Avelar, a Democrat, was elected to the Illinois State House in 2021 to represent the state’s 85th House District, replacing previous state representative John Connor.

Lawmakers listed as “Not Voting” were present for the vote but did not cast a vote. Those marked as having an “Excused Absence” were not present and formally provided a reason for their absence, which was accepted.