Medical debt will once again hurt your credit score in Pa. But patients in N.J. and Del. have protections.

Patients in Delaware now have stronger protections from medical debt affecting their credit score than do residents of many states, including Pennsylvania.

As of July, unpaid medical bills cannot be used to determine a person’s creditworthiness in Delaware. New Jersey and a handful of other states have similar laws, but Pennsylvania does not. Research has found that medical debt is different from other types of debt, such as unpaid credit card bills, and is not a good indicator of whether a person will default on a loan.

The state-level protection is increasingly important after a federal judge reversed a rule from President Joe Biden’s administration banning medical debt from being reported to credit agencies, said Delaware Sen. Spiros Mantzavinos, a Democrat who sponsored the legislation.

“It’s up to the states to set up and protect people,” Mantzavinos said. “Regardless of what happens in the Texas lawsuit, Delawareans are going to be protected.”

The court ruling, however, leaves it unclear whether state laws could ultimately be affected by the legal debate over federal protections.

Pennsylvania does not ban medical debt reporting, but lawmakers are discussing steps to make it easier to apply for debt relief. A bill that would require standardized hospital financial aid forms was approved by the Pennsylvania House of Representatives in May and is awaiting consideration in the Senate.

The policy reversal comes as federal cuts to Medicaid are expected to lead millions of Americans to become uninsured, which analysts expect could increase personal medical debt by $50 billion.

Lawmakers and advocates are worried that weaker medical debt protections will be most harmful to families that are already struggling financially and could see their unanticipated medical costs rise.

Going into medical debt is increasingly a worry for Paula Bussard, 70, of Cumberland County, who cares for her adult son. She and her husband, 75, already tap into their retirement savings for Alex’s care when needed.

She said they would likely go into medical debt caring for her adult son if his Medicaid benefits are cut.

Alex, who is 40, was treated for a brain tumor when he was 12. Two years ago, he experienced a brain hemorrhage and was hospitalized for five months. He still struggles to move his arms and legs independently.

» READ MORE: The ‘big, beautiful bill’ is poised to cut Medicaid. Here’s what’s at stake for five Philly-area families.

New rules pushed by Republicans and Trump would require people with Medicaid to renew their plans every six months and meet monthly work requirements. Service cuts are likely as states grapple with a major funding loss.

People with disabilities, like Alex, should be exempt from those requirements. But Bussard worries that the family could see changes to how his services and medications are covered, she said during a press event about Medicaid changes with Lt. Gov. Austin Davis and advocacy groups. They could be forced to find new doctors if providers decide to stop accepting Medicaid.

“Medicaid already doesn’t cover enough,” Bussard said. “But he’s our son. We love him to pieces and I would not want to see his quality of life diminish any more than it has.”