Federally qualified health centers, created to serve as medical safety nets for low-income Americans, are suing patients for unpaid bills and garnishing wages—contradicting their stated mission and harming the most vulnerable populations they were designed to help.
ProPublica identified at least 1,000 lawsuits filed by PrairieStar Health Center, a nonprofit community health center in Kansas, against patients since 2020 for unpaid medical debt. Many defendants were uninsured or made so little money they qualified for discounted sliding-scale care. Similar patterns emerged at other centers: Eastern Shore Rural Health in Virginia filed more than 7,000 lawsuits over a decade in two counties with just 45,000 residents, suing one couple for $59 in January 2024—a sum that ballooned by more than 600 percent after interest, court costs, and lawyer fees.
Community health centers receive federal grants requiring them to serve patients regardless of ability to pay. Federal law mandates they make “every reasonable effort” to collect money from patients before writing off debt. However, experts say the law does not require outsourcing collections or pursuing wage garnishment—practices some centers have adopted. Medical debt disproportionately burdens Black, Hispanic, low-income, and uninsured patients, groups more likely to use community health centers for affordable care.
The consequences extend beyond finances. Miriam Straus, policy adviser for Community Catalyst, warned that “patients who have been sued because of medical debt are likely to avoid care in the future,” violating the spirit of federal requirements to provide services available to all. Some centers take different approaches: Community Health Center of Southeast Kansas, based in a county with a poverty rate nearly twice the state average, refuses to send patients to collections and instead wrote off about $5.3 million in bad debt last year—about 5 percent of total revenue. Virginia recently passed a law prohibiting large medical providers from garnishing wages for patients qualifying for financial assistance, though many states lack similar protections.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://truthout.org/articles/health-centers-meant-to-make-care-affordable-are-suing-patients-for-unpaid-bills/