A church group in Winston-Salem and the North Carolina state government have each undertaken separate initiatives to address medical debt, a financial burden affecting an estimated 1 in 12 Americans nationally, totaling $220 billion.
Church-Led Fundraising Campaigns
Trinity Moravian Church in Winston-Salem has conducted eight medical debt relief campaigns since 2022. The church’s most recent effort raised over $17,000 to retire more than $2.2 million in debt.
The church partnered with Undue Medical Debt, a nonprofit organization that purchases unpaid medical bills at a reduced rate. Church members, who hold a range of political views, donated small amounts, typically between $25 and $50, to fund the purchases. Pastor John Jackman reported that fundraising was straightforward, as congregants readily contributed.
Catherine Coe, a conservative voter, and Terri Mabe, a liberal voter, both support the initiative. Coe stated that medical debt affects people regardless of politics. Mabe noted the difficulty of paying medical bills during periods of unemployment. Paul Sluder, a former credit union employee who previously collected debts, said most debtors wanted to pay but lacked control over medical emergencies.
"Medical debt affects people regardless of politics." — Catherine Coe, conservative voter
At a ceremony, Pastor Jackman burned a list of 1,631 names, representing the debt that had been retired. Congregation member Cynthia Tesh expressed hope that bipartisan efforts on medical debt could reduce political division and encourage mutual support.
Statewide Program for 2.5 Million Residents
The state of North Carolina has initiated a separate, statewide program to eliminate medical debt for approximately 2.5 million residents. All 99 hospitals in the state have agreed to discontinue collection on specific debts dating back to 2014. They also agreed to automatically provide care discounts for patients eligible for financial assistance, removing the application burden. For a family of four, an annual income below $96,000 qualifies for this assistance.
The Undue Medical Debt charity collaborated with hospitals to identify eligible individuals. One resident, Dawn Daly-Mack, reported that her $459 debt from a 2014 emergency room visit was cleared. The initiative was developed by Kody Kinsley, former North Carolina Secretary of Health. The plan involved linking additional Medicaid funding for hospitals to their participation in the debt relief effort, dating back to 2014, which was the earliest opportunity for the state to expand Medicaid.
A 2025 survey for Undue Medical Debt found that approximately 75% of Republicans and 90% of Democrats opposed wage garnishment for medical debt collection.
Broader Context and Other State Approaches
Other states have adopted various approaches to medical debt:
- Arizona and New Jersey have utilized state funds for debt forgiveness.
- Oregon and Illinois conduct screenings for financial assistance eligibility.
- Colorado and New York have enacted bans on reporting medical debt to credit agencies; federal protections were recently reversed.
"The variability of protections across states suggests federal rules may be necessary for comprehensive impact." — Heather Howard, Princeton University
Heather Howard, director of Princeton University's State Health and Value Strategies program, commented that the variability of protections across states suggests federal rules may be necessary for comprehensive impact. She also noted that potential Medicaid cuts and an increase in uninsured individuals could pose challenges for hospitals in maintaining these debt relief initiatives.