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The IRS won’t take your refund for a hospital debit but the state can do that.
The IRS can only offset your refund for federal debts (a debt to the federal government), student loan debt, back due child support, or repayments of unemployment compensation.
Remember that your federal refund (IRS) and state refund are calculated differently, claimed on different forms, processed by different agencies, and paid separately. If you are expecting a total refund of (for example) $1000, but that is really $600 from the IRS and $400 from the state, you must track both refunds separately.
Also, even if the state withheld your refund for a state-level debt, that does not mean it was instantly applied to the debt. There may be a delay for the payment and paperwork to be processed.
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