New medical debt relief incentive program to level disparities in North Carolina –
How medical debt affects communities
Karida Giddings, the healthcare program coordinator for the North Carolina Black Alliance, said medical debt is intertwined with issues including housing disparities and food insecurity.
In a meeting, Giddings said she heard about a North Carolina resident who lost partial equity of his house to settle over $20,000 in medical debt after his wife died.
Insurance companies deny many claims for medications or surgeries that providers deem medically necessary, causing patients to pay out of pocket, Kate Daley, the health justice campaigner for Down Home North Carolina, said. Down Home North Carolina is an organization serving working-class people and rural communities.
“People with a higher income have the ability to set up payment plans and pay off their debt, but if you live on a fixed income or a low income, you’re in a position of making really impossible choices between health care and housing and food and other basic necessities,” Daley said.
Giddings also said communities of color, particularly in rural areas, are disproportionately impacted by medical debt due to a lack of resources from hospital closures and the delay in expanding Medicaid in North Carolina.
25 percent of North Carolina residents in communities of color experience medical debt — a five percent increase from the state average, according to 2022 data from the Urban Institute.
“It’s often a result of their lived environment as well,” Giddings said. “They didn’t really have access to the health care that they needed and should have had access to in the first place where they may have had more affordable options, and they [had to] default to going to emergency departments because of the absence of facilities with primary care providers.”
Impact of medical debt relief
Due to a rise in high deductible health plans and inadequate insurance, people are talking more openly about the challenges of medical bills they cannot afford, Eva Stahl, the vice president of policy and programs at Undue Medical Debt, said.
“It’s really important that — as we make these changes in policy that are so important for improving health care access — that we’re also still collecting data and understanding how many bills are going unpaid and how that is affecting everyday people,” Stahl said.
Daley said the medical debt relief program proposed by Cooper will mitigate the wealth gap and provide the economic and psychological safety that people need.
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“It can really help to level the playing field and level those disparities that are really harming people, and give patients more peace of mind about their medical expenses,” she said.
On Aug. 12, Gov. Cooper announced that all acute care hospitals in the state have agreed to implement the medical debt relief program, including UNC Hospitals, WakeMed hospitals and Atrium Health hospitals.
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