A new study out of Massachusetts puts devastating clarity behind something patients and advocates have been saying for years: in the United States, your financial health can determine whether you survive a cancer diagnosis. 

Researchers matched data from 90,000 Massachusetts cancer patients with national credit reports and found that when a patient’s credit score drops by two tiers in one year, their risk of dying increases by 29 percent. If that drop happens within six months, the mortality risk increases by 63 percent.

Two patients with the same cancer diagnosis can face dramatically different survival odds — not because of biology, but because of financial strain.

This is the definition of a health system that is failing people.

And it’s not abstract. We see the human cost every day.

A storyteller holds a framed photo of his late wife while standing in his living room. He is wearing a grey shirt.
After being hit with high medical bills and unfair collection practices during his late wife’s and his own cancer battles, Terry is leaning into his power to advance a national movement to end medical debt.

When we met Terry Belk in 2024, he was grieving the loss of his wife to breast cancer and navigating his own recent cancer diagnosis. Instead of being able to focus on caregiving, healing, and mourning, Terry found himself fielding calls from aggressive debt collectors over bills the couple had accrued just trying to stay alive. 

After losing his wife, Terry was diagnosed with prostate cancer. The medical bills kept coming. The collectors kept calling. Like so many families, Terry had to choose between treatment and financial catastrophe; between stability and survival. 

His story mirrors the concerns of the Massachusetts study: financial toxicity — the crushing burden of medical bills, lost income, and mounting debt — is not secondary. It directly shapes who lives and who dies.

A storyteller sits in a living room with a dining table and framed photo of his late wife in the background. He is wearing a grey shirt.
After being hit with high medical bills and unfair collection practices during his late wife’s and his own cancer battles, Terry is leaning into his power to advance a national movement to end medical debt.

Despite several cards stacked against him, Terry refused to let his family’s suffering be invisible. With support from Community Catalyst and the North Carolina Justice Center, he shared his experience publicly. It gained national attention. And then something remarkable happened.

Shortly after his story was featured on NBC News and in local media, Terry received some incredible news: An Atrium Health representative called Terry to say that his debt was forgiven.

More broadly, Atrium Health announced it would forgive medical debt for low-income patients, remove liens on over 11,500 homes, and revamp its financial assistance policies.

Terry’s courage helped move one of the largest systems in the region toward meaningful change. But it shouldn’t take a grieving husband going public during his own cancer treatment to trigger basic fairness.

This study is not an outlier — it’s a warning.

The Harvard findings make clear:
  • People with lower incomes and worse credit — disproportionately Black, Latinx, immigrant, and rural families — face higher mortality long before a crisis hits.
  • Even insured patients often face unaffordable out-of-pocket costs.
  • When premiums spike — as they are right now — families make impossible choices: downgrade their plans, drop coverage entirely and skip treatment, or put less food on the table.  

Financial stress is not just emotionally devastating. It materially affects whether someone receives care in time, completes treatment, or gets follow-up.

This study was done in Massachusetts — a state with one of the highest insurance coverage rates in the country. Outcomes in states with fewer protections, weaker safety nets, more uninsured people, and higher medical debt burdens will likely be even worse.

All of this is unfolding as millions brace for historic coverage losses and unprecedented premium increases due to H.R. 1. 

This is solvable — and states and communities can lead the path to change right now.

We don’t have to accept a system where cancer survival depends on whether you can avoid debt collectors. 

Policymakers can take action immediately: 
  • Ban medical debt from credit reports 
  • Prohibit other harmful medical debt collection practices like wage garnishment and placing liens on homes
  • Expand financial assistance at hospitals and make it automatic for some patients, such as those who receive means-tested benefits or are experiencing homelessness
  • Prohibit hospitals from selling debt to aggressive collectors
  • Hold hospitals accountable for fair billing and collection practices
  • Prohibit predatory deferred interest credit cards from being offered in any health care setting 

Hospitals, policymakers, and community leaders can learn from what happened in North Carolina. When people tell their stories — and when advocates work alongside them — systems can and do change. 

How We Are Meeting the Moment 

This crisis demands coordination across local, state, and national levels — and that’s exactly where Community Catalyst is positioned. 

We bring: 
  • A bird’s-eye view of what’s happening in communities across the country, in response to issues like premium spikes to coverage losses to hospital billing trends
  • Deep relationships with community and state partners who see the impact up close and drive grassroots solutions
  • National policy expertise, pushing for federal protections that safeguard families from financial ruin
  • Storytelling and narrative power, working with people like Terry to ensure lived experience drives policy and accountability
  • A commitment to building power with communities, not on their behalf 

This is the moment to act — before coverage gaps widen, before more families face medical bankruptcy, before financial harm continues to cost lives.

If you’ve faced medical bills or premium hikes, your story matters.  

Your experience can drive change — just like Terry’s. 

You can help make sure policymakers don’t ignore what families are facing. 

No one’s chance of surviving cancer — or any illness — should depend on a credit score, a billing code, or a debt collector. 

We deserve a health system that treats people, not their finances. And together — with community, state, and national partners working in lockstep — we can build it.