The Untold Story of Medical Debt

How can the church help people who are drowning in unjust debt?


About four years ago, as Rev. Chick Lane and I were traveling back from a stewardship event in East-Central Wisconsin, I received a phone call that would change my and my family’s life forever. Chick and I had been chatting away as we drove, as old friends do, and when I finally grabbed my phone out of my purse to check my calendar I saw that I had five missed calls from my husband. Now my husband is the type of guy who rarely calls twice in a row so I was alarmed to see he had called five times. I immediately called him back and was greeted by the voice of a paramedic who assured me that my husband was breathing and conscious, but he had been injured in a serious car accident.

My husband sustained injuries to the ribs, one knee, and one ankle. He underwent surgery the day after the accident and was hospitalized for two days. The next few months, while my husband was on short-term disability recovering from his injuries, was a sea of doctor’s appointments, prescriptions, physical therapy, and phone calls to insurance providers. While I’m happy to report that due to my husband’s determination, perseverance, and strict adherence to the doctor’s orders, he has made an almost full recovery but, he will continue to be in pain everyday for the rest of his life.

Medical Debt as Financial Trauma

As traumatic as the entire experience was for both my husband and I, particularly in the first few days and weeks, the trauma would only be heightened as the bills came rolling in. I will never forget the first hospital bill I received which amounted to more than the cost of my entire first year of college. I was in complete shock as the bills continued to add up. Keeping up with the bills and various insurance policies to ensure everything was paid in a timely manner became a part-time job. While my husband received medical care for only six months following his accident, it took us two and half years to get all of the bills sorted and paid. During that time, one bill ended up in collections because the provider forgot to bill us and one hospital bill took over a year to resolve because it had been billed incorrectly. Had I not understood the details of our health insurance plan and had relationships with people who could help me navigate this complex system, I would have followed the hospital’s advice to start a payment plan to repay this bill which was for over $22,000.

Why would I share this story like this? This month’s theme is trauma, and we’re focusing specifically on financial trauma. Over the last ten years, I’ve seen the issue of debt move to center stage in financial wellness initiatives—which I applaud. However, the debt that’s most often talked about is student loan and credit card debt. Medical debt is almost always left out of the picture.

According to the U.S. Census Bureau

  • 19% of U.S. households could not afford to pay for medical care upfront, or when they received care, in 2017.
  • Among households with medical debt, the median amount owed was $2,000.
  • Households with children under 18 (24.7%) were more likely to carry medical debt than those without children (16.5%).
  • Black (27.9%) and Hispanic (21.7%) households were more likely to carry medical debt than white (17.2%) or Asian (9.7%) households.
  • The percentage of households impacted by medical debt did not vary based on whether the family was living above or below the poverty line. 
  • Households with health insurance coverage for all family members for the whole year (16.2%) were less likely to have medical debt than those who were not fully insured (30.8%).
  • Even those who are fully insured may still struggle to afford health care. 
  • 4% of households have high medical debt, which is defined as debt which exceeds 20% of a household’s annual income.

The Church’s Response

While I’m sure we can all agree that medical debt is traumatic, what can the church do about it?

  • Talk about it: For so many people medical debt is made even more painful and shameful because it remains hidden. One of the best things that a church can do is create space to talk about all that’s going on in our lives, including medical debt. How might you normalize the conversation about such a weighty topic? Share about the impact of medical debt in a sermon or adult education hour. If you have experienced medical debt (or high medical bills) yourself, take the vulnerable step to share your story. This may give someone else the courage to share theirs.
  • Provide financial support: Particularly in the wake of COVID, many congregations have started small emergency funds to help members of the congregation and community with needed expenses. If your congregation has this support available, you might consider adding medical debt to the list of needs you support. Bear in mind that those experiencing medical debt may not be accustomed to asking for support and may feel as if they are taking away money from someone else who is “more worthy.” Make sure the available funds, qualifications, and application process are transparent and easy to access so people understand the money is available for all those in need. Next week, we’ll hear about a congregation who has taken this support to the next level by buying all of the medical debt for their state and forgiving it.
  • Offer financial education: While an emergency can knock even the most financially savvy person off course, financial education can help people prepare for the unexpected and prevent high levels of medical debt. Financial education can also assist congregations in supporting their members as they consider how they will steward all of the money in their life—not just the money they give to the church.
  • Acknowledge the impact it might have on generosity: One important time to bring up medical debt is when you’re talking about generosity. Often church leaders focus so much on the positive impact of generosity that we forget to acknowledge the things that might hold back a giver from giving as generously as they would like to be. For many people, one of the key things that holds them back is debt. Unexpected medical debt, in particular, can get in the way of someone fulfilling a pledge to the church and may hinder them from giving more in the future. Letting people know that you care about this issue and understand it is vitally important. Similarly, this may also be a good time to remind people that financial situations change all throughout the year and if someone cannot meet the commitment they made to the church, there is hope that others in the community whose financial situation has changed for the better will be able to help to fill in that gap.

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