Emily Stewart, Executive Director of Community Catalyst, issued the following statement following the President’s State of the Union address last night: 

“We applaud President Biden for using his most high profile address of the year to focus on affordability and equity in our health care system. What the nation saw on Thursday night was a president proudly advocating for increasing access to health coverage and addressing the crisis of affordability.  

“The President’s address was not only a strong defense of critical programs like Medicaid, Medicare and the Affordable Care Act – programs that bring health care to tens of millions of people –  but a forceful case to expand and permanently enshrine policy that make these programs more accessible and affordable. As an organization that has spent more than a decade working in partnership with communities across the nation to expand Medicaid and make Marketplace coverage more affordable, we are encouraged to see the President commit to finishing this work. 

“However, there is more the President can and should do, particularly when it comes to medical debt. Though he did not directly address it last night, we will continue to push the administration to ban medical debt from credit reports, bar predatory medical credit cards from being offered in care settings, hold non-profit hospitals accountable to their tax breaks and address the growing threat of private equity ownership of health care.  

“Even absent these stated policies, last night, it was clear that the Biden administration is focused on a health care system that is more affordable and more equitable. And that is a big victory.” 

The Medical Debt Crisis and a Call to Action: 

Thursday night, before and after the President’s State of the Union address, Community Catalyst ran television ads urging policymakers in Washington to take action on medical debt. The ads ran on MSNBC and featured Sherrell of Georgia and Aracely of Illinois. They are just two of the nearly 100 million people in America, including 4 in 10 adults, impacted by medical debt.  

In the ad, Sherrell (pictured below) shares: “It is very sad, when your mind as a patient, is thinking [of] cost versus care. Medical debt is just another bill that compounds that person’s life.” Determined to use her experience with medical debt to help others, Sherrell co-founded SOWEGA Rising, a non-profit focused on building community power in her hometown of Albany, Georgia and its surrounding communities. She recalls her stack of medical bills – next to the usual monthly bills – and how the phone would ring only for it to be another collection call. Sherrell was determined to use her experience to help others. People shouldn’t have to worry about cost when they are facing a medical need or crisis, she thought. They should be focused on care. 

Sherrell poses for a portrait at her home in Georgia with her living room blurred in the background.
Sherrell, a resident of Georgia, shares her experience with medical debt to help others in her community.

In the ad, Aracely (pictured below) shares: “No one wants to be sick and choose between life or debt. The burden of having to choose treatment or having to pay my bills shouldn’t have to fall on me.” Aracely, a resident of Illinois, was first diagnosed with breast cancer in 2018, and underwent a double mastectomy. It was difficult to keep up with the bills, but she managed. Three years later, while in remission, she became pregnant with her second child. She had a baby boy in June 2021. Then, she learned that the cancer had returned. Even with health insurance covering some of her costs, it was scary to see so many “zeros” on each bill, representing thousands of dollars in medical expenses. Aracely didn’t choose to become sick, but Aracely did have to choose between treatment or medical debt – an immense burden during a time when she needed to focus on her health and family. 

Aracely poses for a portrait at her home in Illinois
Aracely, a resident of Illinois, shares her experience with medical debt and having to choose between life or debt.

Thanks to multi-issue advocacy, community-driven organizing, as well as robust storytelling and reporting, there is widespread attention on the health and economic impacts of the medical debt crisis in America. In fact, a new study from the American Cancer Society shows that medical debt is associated with worse physical and mental health outcomes, as well as premature death.  

And, while medical debt can impact anyone, including people with insurance, the reality is that it doesn’t impact everyone the same. Due to racism, classism, and other forms of oppression, Black adults (16 percent) report a disproportionate amount of medical debt compared to white adults (9 percent) – and states that have blocked Medicaid expansion continue to have higher rates of medical debt. It is a growing crisis that is impacting people in red states and blue states; in urban areas and in rural areas.  

The Biden administration clearly understands the importance of addressing this issue. Since taking office, they have taken important steps to address medical debt. But there is more they can and should do to address the medical debt crisis on the scale that is needed.  

Specifically, the Biden administration should: 
  • Bolster hospital financial assistance policies to prevent people from incurring medical debt in the first place. 
  • Regulate excessive charges from non-profit hospitals who are obligated to provide charity care or financial assistance to patients in exchange for their tax-exempt status. 
  • Protect people from harsh billing and collection practices like foreclosures, wage garnishment, and bank account seizures. 
  • Prevent non-profit hospitals from denying care to individuals with medical debt. 
  • Strengthen enforcement of regulations to ensure non-profit hospitals are providing sufficient community benefits, and making reasonable efforts to determine whether individuals are eligible for financial assistance prior to initiating extraordinary collection actions. 
  • Prohibit all medical debt from showing up on credit reports by enhancing protections in the Fair Credit Reporting Act (FCRA).  
  • Eliminate the promotion of predatory deferred interest credit cards in medical settings, such as doctors and dental offices, as well as hospitals.  
  • Undertake aggressive enforcement against unfair, deceptive and abusive hospital practices which can prevent debt from being waived or forgiven by hospital policies. 

Learn more about the Community Catalyst campaign to end medical debt and take action by signing our petition urging the Biden administration to hold non-profit hospitals accountable to their tax breaks. 


About Community Catalyst:  

Community Catalyst is a national organization dedicated to building the power of people to create a health system rooted in race equity and health justice, and a society where health is a right for all. We’re an experienced, trusted partner to organizations across the country, a change agent to policymakers at the local, state, and national level, and both an adversary and a collaborator to health systems in our efforts to advance health justice. We partner with local, state and national organizations and leaders to leverage and build power so that people are at the center of important decisions about health and health care, whether they are made by health care executives, in state houses, or on Capitol Hill. Together with partners, we’re building a powerful, united movement with a shared vision of and strategy for a health system accountable to all people. Learn more at communitycatalyst.org.