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Medical debt has destructive effects on Americans

As the cost of healthcare and medical treatment increases, people across the country are struggling to make payments and receive the care they need.

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By
Abbey Slattery
, WRAL Digital Solutions
This article was written for our sponsor, N.C. Justice Health Advocacy Project.

According to data from CNBC, around one third of Americans currently have medical debt. Of those with medical debt, over a quarter owe more than $10,000. Out-of-pocket, Americans spend around $5,000 on medical care every year.

As the cost of prescriptions and medical care shows a steady year-over-year increase, many people are left wondering how to cover the costs of care — especially if they're underinsured or fall into the Medicaid coverage gap.

"We have incredibly expensive healthcare in this country, and in a lot of cases, even people with insurance end up with medical debt, because a lot of people are underinsured," said Rebecca Cerese, the health engagement coordinator at the North Carolina Justice Center. "If you fall into the Medicaid coverage gap, that means that you don't have the ability to get subsidies for the marketplace, nor do you qualify for Medicaid coverage. That leaves you completely uninsured. So what happens when you end up sick or have an accident or are suffering from substance use disorder? Oftentimes people put off getting care."

According to Cerese, the looming threat of medical bills prevent people from seeking treatment early, leading to even more expensive emergency room bills down the line. Without the money to pay outstanding costs, those bills get sent to collections, and eventually affect people's ability to make major purchases like homes or cars — and in some cases, rent and apartment or get a job.

In her line of work, Cerese has seen firsthand just how destructive medical debt can be.

"One woman I've spoken with used to be a truck driver, and she started not feeling well, but they couldn't really figure out what was going on. They finally diagnosed her with diabetes, which caused her to lose her job and her insurance, and since we haven't expanded Medicaid, she was unable to get any kind of coverage," said Cerese. "She ended up getting sicker because she had to ration insulin since it was costing her around $1,300 a month. She suffered several heart attacks and a stroke, all because our state hasn't expanded Medicaid."

"She went into massive amounts of debt, and she can't marry her partner, because then the debt will fall on him, too. In fact, every time her phone rings and it's a number she doesn't know, she completely panics because it might be a collection agency," she continued. "That's what ends up happening. It's causing so much more stress on people who are already suffering."

Over the past ten years, rising health care costs have impacted people from all walks of life. According to research from the Journal of American Medical Association, from 2010 to 2018, over a quarter of all campaigns on the crowdfunding site GoFundMe were health-related. While the number of health-related fundraisers on the site in 2010 was just 42, by 2018 that number grew to 119,373.

Collectively, the total of all these campaigns was $10.3 billion and only $3.7 billion was raised.

"We're not giving our people in North Carolina the tools they need to get healthy and to get better, and we're forcing them to go into deep medical debt if they get sick," said Cerese. "One woman I spoke with broke her arm. She did not want to deal with the debt of going to the emergency room, so she literally duct-taped her arm. Of course it ended up healing horribly and now doesn't work properly — this is what we're forcing people to do rather than providing the coverage and care they need."

Healthcare and insurance coverage are hot topics in political discourse, and legislation for each often changes every few years. For Cerese, an expansion in coverage is the end goal.

"Medicaid is jointly run by the state and the federal government, and the federal government pays two-thirds of the cost for traditional Medicaid. For expansion, it's covered at 90%, so North Carolina would only be on the hook for 10% of that cost," said Cerese. "In the end, if we actually want to be a state that cares about its people, it's a no-brainer."

This article was written for our sponsor, N.C. Justice Health Advocacy Project.