(Raleigh, N.C.) — State Treasurer Dale R. Folwell, CPA, spoke out to protect patients from the crushing medical debt that burdens Eastern North Carolina during a public hearing on the Medical Debt De -Weaponization Act in New Bern on Tuesday, Dec. 13.
Treasurer Folwell was joined by state Rep. Edward Goodwin, a lead sponsor on the bill; Derek Burress, Greene County commissioner; Linda Rouse Sutton, Lenoir County commissioner; and Jessica Kozma Proctor from the North Carolina Retired Governmental Employees Association, as well as other community leaders. They highlighted the failures in patient protections that have helped make Eastern North Carolina home to some of the worst concentration of medical debt in collections in the nation.
“We’re now in this situation not because of the murderous invasion of Ukraine, not because of COVID, and not because of acts of God,” said Treasurer Folwell. “It is because of health care and health care billing where people can’t see themselves past their poverty.”
Medical debt risks creating generational poverty in Eastern North Carolina. Up to 44% of families are in medical debt collections in the counties surrounding New Bern — more than three times the national average. Eastern North Carolina is also home to some of the highest levels of poverty, infant mortality and heart disease in the state. Nationally, nearly 40% of Americans reported cutting back on food, utilities or gas to pay health care bills. Health care costs drove almost half of adults to report delaying or skipping necessary medical care.
The Medical Debt De-Weaponization Act, House Bill 1039, would help working families avoid financial ruin just because they got sick. It would strengthen patients’ access to charity care, limit unfair tactics in debt collection and restrict the ability of large medical facilities to charge unreasonable interest rates on medical debt.
“We are talking about multibillion-dollar corporations that are disguising themselves as nonprofits,” said Treasurer Folwell. “They don’t pay sales tax, don’t pay income tax, don’t pay property tax. Everybody in this room cares about public education, public safety and public roads. Those are the taxes that fund those things.”
North Carolina currently ranks in the bottom half of states for its failure to guard patients’ financial health. Worse, North Carolina is one of the most unaffordable and monopolistic states for health care, and fewer than 25 of its nonprofit hospitals justified their tax exemptions with charity care spending. Some hospitals instead billed $149 million to poor patients – or encouraged thousands of patients to open “medical credit cards” that can charge up to 18% interest on medical debt. Hospitals even sued hundreds of patients over medical debt during the pandemic.
“Right is right and wrong is wrong,” Rep. Goodwin said. “Who am I supposed to help — the richest, or the poorest and middle income? My God tells me I’m supposed to help anybody in need.”
The Medical Debt De-Weaponization Act would make North Carolina second in the nation for consumer protections against medical debt. It would help the state hold hospitals accountable for their charity care and billing practices.
“You’re already paying for it,” Burress said. “The nonprofit hospitals get tax breaks in exchange for helping these needy individuals. … This bill is going to hold these health care facilities accountable.”
“When you go to work as a state employee, you are told that you won’t make a big salary, but that’s ok because you’re told that you will get good benefits,” Sutton said. “Now [health care costs] are 20% of their paycheck, and so often they can’t afford it. … I’d talked to folks who’ve actually had to decide if they’re going to get medicine, or if they’re going to get food.”
The State Health Plan, a division of the Department of State Treasurer, provides health care coverage to more than 750,000 teachers, state employees, retirees, current and former lawmakers, state university and community college personnel, and their dependents.