Removing debt barriers: How we can improve access to medical repayment options

Written by: Mathieu Despard

SaverLife members face challenges with debt. In fact, so far in 2024, over half (51%) of members say that debt is unmanageable for them. 

Medical debt — which totals $220 billion in the United States — is an especially crippling type of debt. It can be completely unexpected and come from factors beyond people’s control, including: accidents, genetic predispositions for certain types of disease, and high healthcare costs. In a recent survey, 27% of SaverLife members said they had trouble paying medical and dental bills while 14% said they put off getting healthcare they needed so they could afford their rent or mortgage payments.

What’s most troubling about these statistics is that a lot of our members’ medical debt shouldn’t exist in the first place. Why? Because under the Affordable Care Act (ACA), nonprofit hospitals are required to provide financial assistance to patients with limited incomes, while most for-profit hospitals voluntarily offer this assistance. At SaverLife, we estimate that, based on income and household size, 70% of our members are eligible for a full discount of their hospital bills and an additional 20% are eligible for partial discounts. 

The problem is: most people who qualify for hospital financial assistance don't receive it.

How SaverLife is supporting debt reduction
As with all our efforts, we’re working to address both the needs of our member community and simultaneously conducting research to inform our policy and advocacy efforts at the systems level.

To directly serve our member community, we’re partnering with different organizations that can support their debt reduction efforts — especially when it comes to medical debt. It’s been just under a year since we launched our partnership with Dollar For, an organization helping people with unpaid medical bills apply for financial assistance. Since then, more than 8,000 SaverLife members have connected with them to get support with their medical bills. We also recently partnered with Money Management International (MMI) to offer our members access to financial counseling, because we know that, for our members to make progress on their financial health journeys, we need to make debt reduction more possible.

Moving the needle on repayment options
Even with valuable resources like MMI and Dollar For, wouldn’t it be better if patients who were eligible for financial assistance received it automatically?

This is the direction my home state of North Carolina is going. All 99 eligible hospitals in North Carolina joined Governor Roy Cooper’s Medical Debt Relief Incentive Program. Starting in 2025, all patients who are enrolled in public benefit programs like SNAP and/or homeless will automatically qualify for financial assistance. Additionally, all patients who receive Medicaid will have their medical debt retroactively canceled back to 2014.

All hospitals in the United States should offer automatic financial assistance for patients who meet income eligibility requirements — not just those who receive public benefits. Medical debt is a drag on the financial health of SaverLife members. We’ll continue to help our members deal with debt through the SaverLife platform by partnering with organizations like MMI and Dollar For. And we’ll continue to do research that brings greater attention to public policies that can make medical debt a thing of the past.

Mathieu Despard is the VP of Research and Policy at SaverLife. In this role, Mat leads work to develop actionable insights on the root causes of financial inequality. His goal is to affect meaningful change in the public policy and the private sectors and improve the lives of people and families living on low-to-moderate incomes: a commitment he’s pursued throughout his career as a professor, researcher, and published author.

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