Yves here. I have mixed feelings about charity as a substitute for legal or political action to stop clearly abusive and ought-to-be illegal practices. We wrote extensively about medical debt many years ago. Regularly, the predatory buyers of these debts seek to collect even though the obligations are way way beyond the statute of limitations, or were disputed. In additions the borrowings may be rendered invalid by not having been transferred properly.
The fact that the profiled church, Trinity Moravian Church in North Carolina, needed to spend only $17,000 to retire $2.2 million of medical debt, shows how deeply junky it was.
But the way this game works is that the predatory debt buyers pursue the former patients with these dodgy bills. If the debtor does not respond, which may be merely by writing back and denying the validity of the claim, the creditor can proceed to court and attempt to get a default judgement. Forestalling that or fighting that takes time and often legal expenditures….which the victims sometimes do not have.
So while one should applaud this grass-level help, Trinity Moravian Church should go one step further and find media and activist allies to make this sort of rescue much less necessary. It should be made criminal to sell medical debt that is past the statute of limitations or transferred improperly, for both the seller and buyer, with very high penalties, punitive damages for any victims, are reimbursement of their legal fees and costs. And the individuals, and not just the companies, should be jointly and severally liable. Bankrupting some evil executives might focus a few minds. That won’t stop these bad practices but it will cut way down on them.
By Noam N. Levey. Originally published at KFF Health News
The Rev. John Jackman, who leads Trinity Moravian Church in Winston-Salem, North Carolina, says the church’s medical debt campaign has brought together people across the political spectrum. “This is the easiest money I’ve ever raised,” he says. (Allison Lee Isley for KFF Health News)
Some issues, like immigration or student loans, are too divisive to unite Trinity Moravian Church.
“We’ve got quite a spread of political beliefs,” said the Rev. John Jackman, who leads this 114-year-old red-brick church near Winston-Salem’s old textile mills. Conservative Republicans sit with liberal Democrats. Supporters of President Donald Trump mix with his fierce critics. “It’s definitely a purple congregation,” Jackman said.
But four years ago, when Jackman suggested a new church mission to alleviate medical debt for residents of the wider Winston-Salem area, there was no dissent. “This is the easiest money I’ve ever raised,” he said. “All I do is tell people what we’re doing, and they write me a check.”
Few issues have been more politically explosive in recent years than healthcare, pitting Democrats and Republicans in bitter debates over the Affordable Care Act, Medicaid, and other flash points.
Yet moved by the sense that the medical debts their neighbors faced were deeply unfair, members of Trinity Moravian, no matter their politics, rushed to write $25 or $50 checks to pay off the bills.
They helped advance a movement by churches across the state and the country and inspired North Carolina government officials to tackle medical debt. The effort drew plaudits from conservative radio host Glenn Beck.
The little church’s success also highlighted a patch of common ground in American healthcare — widespread anxiety and frustration that so many patients are ending up in debt.
Earlier this year, Trinity wrapped up its eighth medical debt campaign, part of what the church calls its Debt Jubilee Project. This one raised more than $17,000. That helped retire more than $2.2 million in debt. Medical debt can be bought for pennies on the dollar because creditors believe most debts won’t be paid.
Nationwide, an estimated 100 million adults have some form of healthcare debt. More than half of U.S. adults have had such debt at some point.
At Trinity Moravian Church, which has about 200 members, it wasn’t hard to find stories of crushing medical bills.
“I see people going into debt every minute of every day,” said Catherine Coe, who works in the accounting department of a hospital system. “We’re all just one medical bill from financial ruin.”
Coe grew up coming to Trinity with her grandmother. She drifted away from the church as an adult before rejoining the congregation last year. Coe, who describes herself as a conservative, voted for Trump.
Terri Mabe, who’s been coming to Trinity for decades, is on the other side of the nation’s political divide. She said she can’t stand the president, who she said “had no real concern for the people of this country.”
Mabe, 70, has also seen medical debt up close. She used to work in the construction industry.
“In between projects you are a lot of times without a job,” she said. “Then you get sick. Next thing you know, you owe $5,000, $10,000 that you cannot pay. You’re barely paying your home bills. Then you’re like: ‘I can’t pay it. What do I do now?’”
Both Coe and Mabe said partisan differences don’t matter. “There isn’t a political divide when it comes to medical debt,” Coe said. “It all brings us together.”
Jackman said he got the idea to do something about medical debt during the pandemic, when growing numbers of people turned to the church for help.
“I was hearing about the reason they couldn’t pay their electric bill was because they’d had a few days in the hospital and then they got hit with this huge bill and it snowballed,” he recalled. “And I started hearing this again and again and again.”
Jackman learned about a nonprofit called Undue Medical Debt that buys unpaid medical bills from hospitals and debt collectors so the debts can be retired.
The church’s first campaign, in 2022, set a goal of raising $5,000 to retire about $500,000 in medical debt owed by residents of surrounding Forsyth County. The campaign hit its goal in just six weeks, fueled mostly by donations of less than $50.
Jackman, who’s been a pastor for more than four decades, attributed part of the success to an ethos of the church. “One of our ideas is that we cannot fix everything, but we have to fix what we can in the place where we’re planted,” he said.
Trinity members, no matter their political leanings, also said they see something broken in a system that pushes sick people into debt.
Paul Sluder, 78, who doesn’t identify with a political party, used to work for a credit union. He said he did a lot of debt collecting before he retired.
Most people, he said, wanted to pay what they owed. If they got sick, they often had no choice but to go into debt.
“You have kind of no control. You have to take care of yourself or your loved ones,” Sluder said. “It’s incredibly unfair, and I think the system’s out of whack.”
Polls suggest there’s a lot of common ground around medical debt.
In a 2025 survey for Undue Medical Debt, more than 75% of Republicans and Democrats said collection agencies shouldn’t be allowed to garnish patients’ wages to pay medical debt. And in recent years, bipartisan measures to expand protections from medical debt have passed in blue and red states.
Coe, a Republican, said she would support even more limits on how much medical debt people could be forced to carry. “Why can’t we cap medical debt at a certain dollar amount, and after that it’s either written off or forgiven?” she asked.
After completing the most recent debt campaign, Trinity hosted a special ceremony, assisted by kids from a local Scouting group.
Jackman stood before the congregation and held up a piece of paper with a long list of names, people in the county whose debt had been bought and retired by the church.
“On this day of Jubilee,” Jackman announced, “we act to forgive the debts of many of our neighbors as God has forgiven our debts.”
As the congregation stood, Jackman flicked on a lighter and burned the list of 1,631 names. The paper was consumed by yellow flame. The scouts set off confetti poppers. The choir sang, and the congregation erupted in cheers.
Afterward, members went downstairs for a spaghetti lunch in the church basement, served by the scouts.
Reflecting on the day’s festivities, many members of the congregation said they hoped their work on medical debt could inspire others to bridge political differences and work together.
“There’s just so much division, so much anger,” said Cynthia Tesh, 72.
“We need to look out for one another,” she said. “If we start looking out for one another, things will change. If we start considering other people and not just ourselves, things will change.”
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