Medical debt impacts about half of Missouri adults, leading to unnecessary financial and health harms. Financial assistance – discounts that hospitals give to low- and middle-income patients – can help prevent medical debt before it starts. Gaps in regulation have given hospitals flexibility in setting their own eligibility levels for these programs, leading to inconsistencies in how these policies are written and implemented. Our analysis of FA policies at 112 general hospitals and 51 specialty hospitals in Missouri shows gaps in transparency and accessibility when it comes to billing and collections.