State must address the issue of medical debt

Hospitals often meet patients when their faith leaders do — during transitions into and out of life and in times of crisis.

Yet, recent articles in the New York Times and JAMA Health Forum are just the latest to shine a spotlight on the aggressive billing practices of hospitals across the United States that worsen the disproportionate burden of medical debt carried by Black and Latino/Latina households. While the New York Times focused on an investigation of Rhode Island hospitals, the JAMA article notes how widespread and deeply harmful these practices are, especially for the communities we serve.

Our families are suffering. Medical debt contributes to the cycle of economic and health inequities in our communities. It leads to decreased access to credit, increased likelihood of bankruptcy, and costly and lengthy collection litigation. Many of those burdened with medical bills feel compelled to delay or forgo needed medical care to avoid incurring even more bills they can’t afford.

Furthermore, this debt is often unavoidable. No one can predict a car accident, a stroke, a complicated birth or appendicitis. Such deeply human and common experiences will always take a physical and emotional toll and require the support of our faith communities, but they need not and should not lead to financial ruin. Systemic racism has many consequences, among them limited accumulation of wealth and less access to the most affordable health insurance (employer-sponsored plans). As a result, Black and Latino/Latina families in Connecticut are disproportionately likely to go without insurance and to lack the savings to pay a deductible, copay, or coinsurance when they need hospital-based care.

Even more troubling, nonprofit hospitals are required to offer free and reduced-price care, yet eligible patients often don’t know about these programs and are routinely sued or pursued by collection agents for bills hospital financial assistance programs should have covered. Unpaid medical bills are not just an issue for the uninsured. According to the Connecticut’s Healthcare Affordability Index, two in 10 Connecticut residents overall and seven in 10 people enrolled in health care through Access Health CT have health care costs that exceed their ability to afford basic necessities.

Despite the growing burden of medical debt, Connecticut hospitals spend less than the national average on financial assistance and have been spending less in recent years. Worse, aggressive bill collection practices and labyrinthine processes for accessing discounts cause psychological and financial damage. A 51-hospital system was found to be pressuring patients who were eligible for financial assistance into paying their bills to decrease their uncompensated care costs. Our community members tell us of experiences in Connecticut that are similar — being told no care can be provided without up-front payment or receiving unexpected bills for thousands of dollars after giving birth. In 2019, UConn published a study showing wide variation in small claims court suits brought by hospitals against their patients and the Wall Street Journal covered lawsuits against Yale New Haven Hospital for aggressive debt collection in the early 2000s. In other words, our congregations and the data tell us this problem is rampant right here in our state.

It is imperative that Connecticut’s legislature take action. As people who have dedicated our lives to the spiritual, physical, and emotional wellbeing of our congregations, we urge the state and hospitals work together to ensure that the worst moments in our lives don’t also leave us in dire financial straits. How?

1. Make it easier for patients to learn about and navigate hospital financial assistance by setting minimum standards and streamlining applications.

2. Ensure no one is sued or pursued by bill collectors unless and until they have been screened for financial assistance eligibility and, if they do not qualify, offered a reasonable payment plan.

3. Hold hospitals accountable for screening patients, distributing financial assistance equitably, and abstaining from aggressive bill collection practices.

Reverend Robyn Anderson is the executive director of Ministerial Health Fellowship. She is joined in this op-ed by Rev. Nancy Kingwood, Bishop Peter A. Rosazza, Rabbi Brian Immerman, Rev. Moses L. Harvill, Apostle Dr.

Ethel Graham, Apostle William McKissick, Dr. Paul Hylton, Minister Alan Marshall, Rev. Debra Hopkins, Rev. Sandra Steele, Rev. Kelcey Steele, Rev. Donald Watson, Pastor Lucille Clegg, Bishop Vance, Pastor Kim Cotton, Rev. Kelcey Hopson, Dr. Shelley Best, Rev. Samuel Blanks, Rev. Elvin Clayton, Rev. Patricia Washington-Rice, Rev. Edward Ford, Rev. Kevin Johnson, Dr. Leroy Perry, Pastor Luis Rodriguez, Rev. Brian Riley, Rev. William Campbell, Bishop Fredrick Jackson, Rev. Patricia Flowers, Rev. Mullins, Rev. Lydell Brown, Rev. LaMonika Johnson, Rev. L. Christopher Lewis, Dr. Alice Farrell, Pastor Amarillys Castro, Rev. Brian Riley, Minister Sandra Aidoo, Minister Adrian Barnes, Rev. Terri Williams.