Non-American here: What is the incentive for anyone in the US to pay off medical debt then? Also, I’ve read that medical debt is the number one cause of personal bankruptcy in the US; how does that work?
There is a chance of follow up, and some healthcare providers do. You can be taken to court and forced to pay or declare bankruptcy if you can't.
While the US does legally require some medical care regardless of ability to pay, that's mostly for life sustaining care; healthcare providers to which you owe a large debt may decline to provide healthcare when not legally obligated. That can be a big deal or not depending on your available providers and their policies.
Secondly, it's still a legal debt. That means the billing department will employ escalating collection tactics for large debts where they believe the debtor has sufficient assets.
The non-reportability is a recent change. Also, if the provider sues, whether it’s on your credit report is irrelevant.
Strongly disagree. Being able to take your time to pay a debt when in a cash crunch without worrying about the long-term impacts on your credit is material.