Health Affairs October 17, 2024
Kody H. Kinsley

Medical debt is the predictable and all too pervasive result of the US’s expensive and fragmented health care payment and delivery system. It is a disease within our health system. Millions of low- and middle-income Americans struggle with medical bills after seeking the care they need to live healthy, flourishing lives.

In North Carolina, the threat of having to take on new debt was reduced for more than 600,000 people who became newly eligible for Medicaid when the state expanded Medicaid with broad bipartisan support in December 2023. Yet, many of the new Medicaid enrollees who now have access to comprehensive coverage carry medical debt from before they enrolled.

In response to these persistent burdens, the North Carolina Department of...

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