May 12, 2022
Kathleen Stoll

As our nation continues to feel the impact of COVID-19, there is another health care plague that hangs over many of us. Go to any gathering of family and friends and raise the issue of
medical bills. No matter the political spectrum seated at the table — Republican or Democrat, conservative or liberal — all will agree that medical debt is an epidemic.
When a person’s medical bills exceed what they can pay, they are stricken with medical debt.  Medical debt can get hold of you from many sources, with the largest portion arising from
exposure to emergency room visits, hospitalizations, dental care and diagnostic tests like Xrays and MRIs.

Medical debt is the source of more than half of all debts in collection in the United States.  Certainly, the 30 million Americans who remain uninsured are at high risk of devastating
medical debt. Yet, medical debt doesn’t just strike the uninsured. Twenty-two percent of all insured people have the symptoms of outstanding medical bills. Medical debt among insured folks is caused by high deductibles and copayments, inadequate insurance, complicated insurance claim procedures and opaque billing and collection systems. People with a bad case of medical debt often are forced to exhaust their paychecks and savings to pay medical bills, and consequently reduce their spending on food, clothing and other household items, borrow money from friends or family members, or take on additional debts. Thirty-seven percent of people with medical debt used up all their savings to pay their medical bills, 31% took on new credit card debt, and 11% took out a loan against their home or other type of loan to pay their medical bills.

Medical debt is devastating to your financial health. Being sick and running up medical bills also can end up making you sicker. 

Many people suffering from high medical debt delay needed health care to avoid incurring more medical bills. The result is that a health condition becomes a health crisis and the resulting more-serious health problems cost more and the medical debt skyrockets. This vicious cycle can seem never-ending and without a cure. 

Living with outstanding medical bills creates stress that leads to poor physical and mental health. How many of us have been awake all night worrying about how to pay a medical bill? 

Contrary to what you might hear, medical debt does not go away in seven years. And under federal law, only $217.50 a week in wages are fully protected from garnishment. In many states, collectors can completely empty out bank accounts. 

Medical debt comes in many variants. There is medical debt owed directly to hospitals and providers; medical debt loaded on high-interest credit cards (including provider-promoted “medical credit cards”); high-interest loan companies that specialize in medical debt; and bills owed to providers that are turned over to aggressive third-party collection agencies and profit-driven accounts receivable debt purchasers.

A few band-aids and aspirin have been prescribed. In April, the Biden administration ordered a federal evaluation of providers’ billing practices that might influence how much federal grant money they get. The administration also directed all agencies to eliminate medical debt as a factor for federal credit programs. Three private credit reporting agencies announced that, as of July 1, paid medical debt will be removed from credit reports and people will have 12 months, up from six, to settle medical bills before the debt appears on credit reports.

One medical debt preventive measure was passed by Congress in 2020 (with bipartisan support — it felt like a miracle). The No Surprises Act protects people with health insurance when they receive emergency care or scheduled treatment from doctors and hospitals that are not in their health insurance networks and that they did not choose. Consumers are responsible only for their in-network cost-sharing in these situations.

Until our nation has the true cure of comprehensive, quality, affordable health care for all — the following policies would help ease the medical debt epidemic: 

-- Ban the practice of turning over medical debt to third-party collection agencies.

-- Prohibit providers and debt collectors from reporting medical debt to credit reporting bureaus.

-- Stop aggressive medical debt collection by banning wage garnishment, bank account seizure, property liens, foreclosure of homes based on medical debt liens and civil arrest warrants.

-- Prohibit collection of medical debt during health insurance claims appeals. Increase federal wage protection to the poverty level and protect small bank account balances from
    debt collection. 

Not all afflictions are curable, but federal and state policymakers can ease the burden of our
national outbreak of medical debt.

Kathleen Stoll is policy director for West Virginians for Affordable Health Care (wvahc.org)
and operates a policy and economic consulting business, Kat Consulting