“Every day was hard. Every day, I wonder what I owe, how can I get rid of it? tough.”
Terry Logan, 42, Spartanburg, South Carolina
Estimated medical debt: $1,400, now $0
Medical problems: premature birth
What happened: Two months before her due date with her second daughter, Terry Logan felt overwhelmed with stress. She was a high school math teacher in Union City, Georgia and was ending her relationship with the child’s father.
One day the child stops moving. Logan goes to the hospital, where his blood pressure spikes, his head starts pounding, and he blacks out. A few hours later, her daughter was born by cesarean section, weighing just 3 pounds. Logan had health insurance through work, but was responsible for out-of-pocket charges. She and her baby had a health crisis, so money didn’t come up: “That conversation didn’t happen at that point.”
About two weeks after leaving her daughter, Logan was hit with a bill. He couldn’t bring himself to look closely at Mote. “It was one of those moments when you see … the comma,” he said. He never opened the bills that came after him, knowing he couldn’t pay them or handle the stress. “I avoided it like the plague.”
Other bills followed. Finally, they were sent to collection.
Debt piles on top of other stressors for single moms. He developed debilitating anxiety, which brought more headaches. He had to quit his full-time teaching job. “The weight of all that medical debt — oh, man, it was tough,” he said. “Every day was hard. Every day, I wonder what I owe, how I can get rid of it.”
What’s broken: Logan is among a growing number of working people who are considered under– insured; That is, they have an employer-sponsored plan but it imposes many costs on the patient — in the form of copays, copays, and deductibles.
This cost sharing, as it is called, has grown steadily over the past two decades. Last year, the average annual deductible for a single worker with job-based coverage was $1,669, up 68% from a decade ago, according to KFF’s annual employer survey. The family exemption can be $10,000.
At the same time, millions of Americans have no savings. A nationwide survey conducted by KFF for this project found that half of US adults do not have the cash to cover an unexpected $500 health care bill.
This makes debt almost inevitable for major expenses like having a baby, even if they have health insurance. In fact, according to a KFF poll, most Americans with medical debt had coverage.
With her older daughter, Logan said, she never saw Bill. It was a complicated birth with no out-of-pocket costs. So she assumed her insurance would provide similar coverage for a second birth.
What’s left: About 13 years after the birth of her second daughter, Logan received yellow envelopes in the mail and prepared to open them. He was eventually able to work again, whenever his health permitted. It was time to start dealing with the problem that dogged him.
As he put it: “It was, ‘Well, even if you can’t pay it, you have to know who you owe it to. At some point, you have to start over, because you have to take care of it to get into a better situation.’ ‘”
To her surprise, the envelope wasn’t a bill, but a notice from RIP Medical Debt, a nonprofit, that said it had bought her outstanding medical debts and forgiven them on her behalf. She is shocked: “Wait: what? Who does this?”
Logan read the letter again and wept as he absorbed the unexpected gift. “It definitely gives you a sense of, ‘You know what? There’s still good in this world,'” he said.
RIP Medical Loans use donated funds to purchase unpaid medical loans, directly from hospitals or in the secondary market, at approximately 1% of the original value. It selects the unpaid bills of low-income patients — those making up to four times the federal poverty level — and instead of trying to collect those debts, simply forgives them.
Through the pandemic, donations have skyrocketed, enabling the group to accelerate its hospital loan purchases. To date, it has forgiven $6.7 billion in medical debt, helping 3.6 million people.
Lifting his own debt burden, Logan said, freed him to pursue long-dormant interests. A lover of the stage, she planned her first singing performance this month.
About this project
“Diagnosis: Debt” is a reporting partnership between KHN and NPR that explores the scale, impact and causes of medical debt in America.
The series draws on the “KFF Health Care Debt Survey,” a poll designed and analyzed by KFF’s public opinion researchers in collaboration with KHN journalists and editors. The survey was conducted online and by telephone in English and Spanish from February 25 to March 20, 2022, among a nationally representative sample of 2,375 US adults, including 1,292 adults with current health care debt and 382 adults who had health care debt. last five years The margin of sampling error is plus or minus 3 percentage points for the full sample and 3 percentage points for those with current debt. For results based on subgroups, the margin of sampling error may be higher.
Additional research was conducted by the Urban Institute, which analyzed credit bureau and other demographic data on poverty, race and health status to explore where medical debt is concentrated in the United States and what factors are associated with high debt levels.
The JPMorgan Chase Institute analyzed records from a sample of Chase credit card holders to determine how customers’ balances may be affected by major medical expenses.
Reporters from KHN and NPR also conducted hundreds of interviews with patients across the country; spoke to physicians, health industry leaders, consumer advocates, debt lawyers and researchers; and reviewed scores of studies and surveys about medical debt.