Eve is here. I have mixed feelings about philanthropy as an alternative to legal or political action to stop what should clearly be abusive and illegal behavior. We wrote extensively about medical debt many years ago. Predatory buyers of these debts typically seek collection even though the debts are well past the statute of limitations or are in dispute. Additionally, if not properly transferred, the loan may be invalidated.
The fact that a high-profile church, Trinity Moravian Church in North Carolina, had to spend just $17,000 to pay off $2.2 million in medical debt shows just how junky it was.
But the way the game works is that predatory debt buyers go after former patients with these dodgy bills. If the debtor does not respond, it may simply send the letter back denying the validity of the claim, and the creditor can proceed to court and attempt to obtain a default judgment. Forestry and fighting take time and often involve legal costs…which victims may not have.
So while this grass-level help is to be applauded, Trinity Moravian Church needs to go a step further and find allies in the media and activists to make the need for this type of relief much less. Selling medical debts that are past the statute of limitations or that have been wrongly assigned should be a crime, with very high penalties for both sellers and buyers, punitive damages for victims, and reimbursement of legal costs and expenses. And not only companies but also individuals should bear collective responsibility. The interest of a few people may be focused on bankrupting some evil executives. This won’t stop these bad practices, but it can significantly reduce them.
Written by Norm N. Levy. Originally published on KFF Health News
Pastor John Jackman, who heads Trinity Moravian Church in Winston-Salem, North Carolina, says his church’s medical debt campaign has brought people together across political lines. “This is the easiest money I’ve ever raised,” he says. (Alison Lee Eisley, KFF Health News)
Some issues, such as immigration and student loans, are too divisive to unite Trinity Moravian Church.
“Our political beliefs are pretty widespread,” says the Rev. John Jackman, who leads a 114-year-old red brick church near an old textile mill in Winston-Salem. Conservative Republicans sit alongside liberal Democrats. It’s a mix of supporters of President Donald Trump and his fiercest critics. “It’s definitely a purple congregation,” Jackman said.
But four years ago, when Jackman proposed a new church mission to relieve medical debt for residents of the greater Winston-Salem area, there was no opposition. “This is the easiest money I’ve ever raised,” he said. “All I do is tell people what we do, and they write me a check.”
Few issues have been more politically explosive in recent years than health care, with Democrats and Republicans locked in heated debates over the Affordable Care Act, Medicaid and other flashpoints.
But moved by a sense that the medical debt facing their neighbors was grossly unfair, members of Trinity Moravian, regardless of politics, rushed to write $25 or $50 checks to pay the bills.
They helped advance a movement by churches in the state and across the country to urge North Carolina government officials to address medical debt. The effort drew praise from conservative radio host Glenn Beck.
The small church’s success also highlights a common thread in American health care: widespread anxiety and dissatisfaction with the debt that too many patients face.
Earlier this year, Trinity concluded its 8th Medical Debt Campaign as part of what the church calls the Debt Jubilee Project. This one raised over $17,000. This allowed us to pay off over $2.2 million in debt. Medical debt can be purchased for pennies on the dollar because creditors believe most debts will never be paid.
An estimated 100 million adults nationwide have some type of medical debt. More than half of American adults have incurred such debt at some point.
At Trinity Moravian Church, which has about 200 members, it wasn’t hard to find stories of high medical costs.
“I see people borrowing money every minute of every day,” said Katherine Coe, who works in the hospital system’s accounting department. “We all get away with one medical bill from financial ruin.”
Coe came to Trinity with her grandmother and grew up there. She drifted away from the church as an adult and rejoined the congregation last year. Mr. Coe describes himself as a conservative and voted for Mr. Trump.
“Every minute of every day, we see people in debt,” says Catherine Coe. Coe works in the accounting department of a large health system. (Alison Lee Eisley for KFF Health News) Terry Mabe used to work in the construction industry and has seen the effects of medical debt up close. “You get sick, and the next thing you know you’re $5,000, $10,000 in debt,” she says. (Alison Lee Eisley, KFF Health News)
Terry Mabe, who has been coming to Trinity for decades, is on the opposite side of the country’s political divide. She said she couldn’t stand the president, who she said had “no real concern for the people of this country.”
Maeve, 70, has also seen medical debt up close. She worked in the construction industry.
“In between projects, there is often no work,” she said. “Then you get sick. The next thing you know, you owe $5,000, $10,000 and you can’t pay it. You’ve barely paid your housing costs. And you’re like, ‘I can’t pay. What am I going to do?'”
Both Coe and Mabe said partisan differences were not an issue. “There are no political divides when it comes to medical debt,” Coe said. “Everything brings us together.”
Jackman said he came up with the idea to do something about medical debt as more people turned to the church for help during the pandemic.
“I was told that the reason they couldn’t pay their electric bill was because they were in the hospital for a few days and then this huge bill snowballed and the bill just snowballed,” he recalled. “And I started hearing this over and over again.”
Jackman learned about a nonprofit organization called Undue Medical Debt that buys unpaid medical bills from hospitals and debt collectors to pay off debts.
The church’s first campaign set a goal of raising $5,000 in 2022 to pay off about $500,000 in medical debt owed by residents of surrounding Forsyth County. The campaign, supported primarily by donations under $50, reached its goal in just six weeks.
Jackman, who has been a pastor for more than 40 years, attributed part of its success to the church’s ethos. “One of our ideas is that we can’t fix everything, but we have to fix what we can where we are,” he said.
Trinity members also said they felt there was something broken about a system that forced sick people into debt, regardless of their political leanings.
Paul Sluder, 78, is not affiliated with any political party but previously worked at a credit union. He said he collected a large amount of debt before retiring.
He said most people want to pay off what they owe. When people got sick, they often had no choice but to borrow money.
“You have no control. You have to take care of yourself and your loved ones,” Sluder said. “I think this is incredibly unfair and the system is crazy.”
Polls show there are many similarities when it comes to medical debt.
In a 2025 study on unjustified medical debt, more than 75% of Republicans and Democrats said collection agencies should not be allowed to garnish patients’ wages to pay medical debt. And in recent years, bipartisan bills expanding protections from medical debt have been passed in blue and red states.
Coe, a Republican, said he supports further limits on the medical debt that people are forced to pay. “Why can’t medical debt be limited to a certain amount and then canceled or discharged?” she asked.
After completing its latest loan campaign, Trinity hosted a special ceremony attended by children from local scout groups.
Jackman stood before the congregation and held up a paper with a long list of names of people in the county whose debts the church had bought out and forced into retirement.
“On this Jubilee Day, we will act to forgive the debts of many of our neighbors, just as God has forgiven our debts,” Jackman announced.
As the congregation stood, Jackman lit a lighter and burned the list of 1,631 names. The paper was consumed by yellow flames. The scouts threw confetti. The choir sang and the congregation cheered.
Jackman burns a list of names of people around Forsyth County whose debts the church has bought and repaid. (Alison Lee Eisley, KFF Health News)
Members then went downstairs to eat a spaghetti lunch provided by the Scouts in the church basement.
Reflecting on the day’s celebrations, many members of the congregation said they hope their work on medical debt will inspire others to bridge political differences and work together.
“There’s so much division and anger,” said Cynthia Tesch, 72.
“We need to look out for each other,” she said. “Things change when we start caring for each other. Things change when we start considering others, not just ourselves.”
