Medical debt ties NC residents in knots. Working to undo damage.

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East Carolina University Health Medical Center in Greenville, seen here on March 11, 2025. The majority of high-risk deliveries in northeast North Carolina take place at this hospital, according to ECU. Jane Winik Sartwell / Carolina Public Press<br>" data-large-file="https://i0.wp.com/carolinapublicpress.org/wp-content/uploads/2025/03/hospitals-002.jpg?fit=766%2C404&ssl=1" /> East Carolina University Health Medical Center in Greenville, seen here on March 11, 2025. The majority of high-risk deliveries in northeast North Carolina take place at this hospital, according to ECU. Jane Winik Sartwell / Carolina Public Press

In 2018, postpartum eclampsia kept Jessica McIntyre in the hospital for a week after the birth of her son. McIntyre, a school social worker in Beaufort County, had health insurance, but her plan required her to pay 20% of the cost of her stay. In total, she owed thousands of dollars in medical debt to Vidant Medical Center (now ECU Health).

However, as a new mom, those hospital bills were the last thing on her mind, McIntyre told Carolina Public Press. Eventually, she fell behind on her monthly payments and stopped altogether. That was, until she contacted the hospital some time later to ask about making another payment.

Vidant told McIntyre that it had deemed her debt unrecoverable and sold it to a collections agency. Soon after, her credit score took a plunge.

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“With me having been sick and us not making a lot of money, it was a struggle,” McIntyre said about living with medical debt.

Last year, McIntyre received a curious letter in the mail. It was from a nonprofit organization called Undue Medical Debt, which claimed to have erased all $3,200 of her remaining debt. At first, she was skeptical.

“I was like, ‘this stuff doesn’t happen to me,’” McIntyre said. “This can’t be real.”

But it was very real. McIntyre’s debt had been wiped clean and her credit score rebounded. Her 8-year-old son is happy and healthy, too, she added.

Debt relief at a national scale

Undue, the nonprofit organization which relieved McIntyre of her debt, has bought and erased more than $40 billion of medical debt across the country.

It does so by purchasing large portfolios of unpaid debts for pennies on the dollar — the types of distressed assets that commonly end up in the hands of collections agencies, which attempt to recover the debt at a profit.

People who have their debt erased by Undue don’t need to apply. They are simply notified that they no longer owe that money once Undue has purchased and paid off the debt.

Eva Stahl , who leads policy, engagement and research at Undue, said the impacts of medical debt relief range from the emotional to the pragmatic.

For some, it provides a path toward previously inaccessible lines of credit, such as a home or auto loan. For others, it simply means being able to go out to dinner or buy a Christmas gift free from anxiety or guilt over their medical bills.

“We hear from (recipients) all the time about how, in small and big ways, that really helped them move their life forward and open windows of opportunities,” Stahl said.

“And, importantly, it gives them a sense of hope and relief.”

Medical debt and affordability

Data on medical debt in the United States is limited but suggests a large-scale, pervasive problem.

A 2024 KFF report estimated that Americans were carrying at least $220 billion in debt. That same analysis found that 13.4% of adults in North Carolina reported having medical debt between 2019 and 2021. That was the third-highest percentage among all U.S. states, behind only South Dakota and Mississippi.

Still, those numbers are likely an undercount, Stahl said. The data in the KFF report doesn’t include people incurring credit card debt to pay their medical bills or borrowing from their friends and family.

“Those debts, even though they’re medical debts, tend to be hidden,” Stahl said, “so we know that the scale of the problem is much bigger than that.”

The problem of medical debt could worsen nationwide as forthcoming changes to Medicaid and rising premiums drive up the number of people without health insurance.

But even those who have insurance and are gainfully employed are struggling to keep up with the rising costs of healthcare.

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