Assistance with your medical debt

Congressional testimony

Medical debt training

How medical debt relates to:

Before 2000, not even health policy experts worried much about medical debt. It was assumed that charity care could be found in an emergency room, and that simply allowing bills to go unpaid brough few problems for the debtor.

The Access Project has worked tirelessly to expose how policy decisions and business practives lead to medical debt. Our studies motivated changes in hospital pricing and charity care that previously discriminated against the uninsured. Our effective use of research combined with personal stories compelled the American Hospital Association to issue new guidelines on medical debt collection, and helped build support for laws passed in several states that gave patients expanded rights.

We will continue to raise the debate on medical debt in local, state, and national policy discussions on health care and economic development. We will strive to bring help and counsel to those in need. It will give power to consumers, bringing the voices of people hurt by medical debt into the policymaking arena.


Do you have medical debt?
The Access Project’s Medical Debt Resolution Program may be able to help. We can provide you with information and proven strategies to advocate with medical providers, insurers, and public programs to resolve your medical debt. Please complete our online intake form and you will receive a response from our program within five to ten business days.

If you have a compelling story about past medical debt that has been resolved, please share it with us. Personal stories bring a face to this .....

Our Medical Debt Resolution Program also worked specifically with residents of Massachusetts around Chapter 58.
Between September 2006 and April 2008, The Access Project worked with nearly 200 Massachusetts residents who were struggling with medical debt. We provided one-on-one coaching to help people appeal denied claims with insurers, submit bills to public programs, and negotiate affordable payment arrangements with providers. Our goals were to resolve their affordable medical bills and to identify patterns of policies and problems that created medical debt. Our findings and recommendations are contained in the report.  

In Debt But Not Indifferent: Chapter 58 and The Access Project’s Medical Debt Resolution Program


The Access Project Testifies at Congressional Hearing on Medical Bankruptcy & Medical Debt
Mark Rukavina, Executive Director of The Access Project, testified on July 17, 2007 at the hearing "Working Families in Financial Crisis: Medical Debt and Bankruptcy" of the House Committee on the Judiciary Subcommittee on Commercial and Administrative Law. The hearing focused on medical debt as a contributor to personal bankruptcy. In his testimony, Mr. Rukavina described how the financial burden of health care costs sometimes results in medical debt. He presented information on the prevalence of medical debt, conveyed how it serves as a barrier to health care and explained how it tarnished people's credit He urged regulators to prevent involuntary medical debt from ruining people's credit reports and scores by prohibiting medical providers, and their agents, from reporting such debt to credit agencies.


You can build capacity within your own organization by using our Medical Debt Resolution Program training. For more information on our trainings, please contact Bill Loterro, Field Director at

Sites currently using the Medical Debt Resolution pathway.....

Iowa, Florida, others?


The Access Project has conducted extensive research on the link between medical debt and housing issues. Two of our reports are specific to this problem.

One report is specifc to the state of Missouri. In January and February 2005, a survey of working families in the St. Louis area asked the question: Do you owe money for medical care? Over half (53%) of these families said yes—they owed medical debt. More striking, more than 50% of those who were struggling to pay off medical bills said they had health insurance when they sought treatment. Almost one-third (31%) experienced housing problems due to their unaffordable medical bills.

This report, Living in the Red: Medical Debt and Housing Security in Missouri tells the personal stories that bring life to the statistics on medical debt. Seven Missouri residents from across the state share their personal experiences telling how medical debt affects their access to health care, as well as their families’ financial and emotional stability. As these stories attest, people with medical debt expect to and want to pay for the medical care they receive, but too often family budgets are overwhelmed by the rising costs of care. 

People with unaffordable medical bills are our neighbors, friends, and colleagues. They work hard to support their families and live in small towns, suburbs and big cities. Nonetheless, each of these individuals was unable to avoid the unforeseen illness or injury that disrupted their lives, caused medical debt, and created financial instability and housing problems. Most appalling, most of these folks had health insurance that failed to protect them from the immense costs of medical care.

Download Living In The Red
Press Release

Another report on medical debt and its effect on housing, Home Sick: How Medical Debt Undermines Housing Security is based on a survey by The Access Project and its research partners of 1,700 low- and moderate-income taxpayers in seven cities. Nearly half of those people reported having medical debt and, of those, about a quarter said that housing problems resulted from the debt. The most frequent housing problems were the inability to qualify for a mortgage, difficulty making rent or mortgage payments, being turned down from renting a home, and being forced to move to less expensive housing.

Another significant finding was that many people who reported medical debt and subsequent housing problems had health insurance at the time the debt was incurred, suggesting that insurance, in many cases, is not fulfilling its basic purpose of protecting the insured from financial catastrophe. Home Sick details all of these findings, and lays out potential remedies for policy makers, health care providers, insurers and lenders.

Home Sick: How Medical Debt Undermines Housing Security
Survey Partners
Press Release
Teleconference Speakers’ Bios
Teleconference Speakers’ Statements
Personal Accounts
Resource List (people willing to grant interviews to the press in order to provide more background information.)
Executive Summary

November 9th Conference Call Home Sick: How Medical Debt Undermines Housing Security
A discussion about the impact medical debt has on people's access to housing

Windows Media
WMP (56 kbps)


In collaboration with Demos, The Access Project produced a report in January 2007 titled Borrowing to Stay Healthy documenting how low and middle income households are turning to credit cards to pay for medical care. The report findings are based on a national telephone survey of over 1,100 low and middle income households.

Report highlights include the finding that nearly one-third (29%) of respondents reported that medical expenses contributed to their current level of credit card debt. In households with medical debt, the average credit card debt was significantly higher (46%) that in those households without medical expenses as a contributing factor in their overall credit card debt.
While uninsured respondents had the highest levels of credit care debt, even respondents with health insurance were not shielded from the medical debt problem. These findings, combined with the industry trend of increasing deductibles and other out-of-pocket costs, call into question whether it is prudent to rely on borrowing as a method to pay for needed health care.

For more information on Demos, visit their website at
Borrowing to Stay Healthy
The Plastic Safety Net
Press Release