Governor Josh Stein held a roundtable in Greensboro to discuss the impact of medical debt on North Carolina residents and the effects of recent relief efforts. The event brought together advocates, faith leaders, healthcare professionals, and patients to share their experiences with medical debt and its broader economic implications.
In October, Governor Stein announced that North Carolina’s medical debt relief program had eliminated more than $6.5 billion in medical debt for over 2.5 million people in the state during the past year. “At a time when many Americans are just one emergency medical expense away from going into debt, this relief program is putting more than 2.5 million North Carolinians on the path to financial security,” said Governor Josh Stein. “We are grateful for our partners in this work who are removing this weight and empowering North Carolinians to live a healthier life.”
NC Health and Human Services Secretary Dev Sangvai addressed the consequences of medical debt, stating: “Medical debt often arises unexpectedly and can exceed a person’s ability to pay, damaging credit, limiting access to housing and jobs, and cause people to delay needed care. North Carolina’s groundbreaking program lifts this unnecessary burden and puts into place policies to prevent low- and middle-income North Carolinians from incurring medical debt in the future.”
Governor Stein also sent a letter today to Experian, Equifax, and TransUnion—the three major national Credit Reporting Agencies—urging them not only to uphold their current policies excluding certain medical debts from credit reports but also encouraging them to consider removing all such debts from consumer credit histories.
The relief program was launched in July 2024 using federal resources rather than state funds. It has exceeded its initial financial projections by relieving both existing debts directly through the program as well as additional amounts as hospitals updated their charity care policies.
Since August 2024, every eligible hospital in North Carolina has agreed to participate in what is described as a first-of-its-kind initiative. This effort is supported by collaboration among NCDHHS, 99 acute care hospitals across the state, and Undue Medical Debt—a nonprofit organization working with hospitals on implementation.
The Centers for Medicare and Medicaid Services (CMS) approved policy changes allowing hospitals that relieve medical debt for certain low- and middle-income residents—and adopt more generous charity care rules—to receive enhanced payments under the Healthcare Access and Stabilization Program (HASP). Neither HASP nor Medicaid expansion required new state spending.
Hospitals must now improve processes for determining eligibility for charity care or financial assistance while ending reporting of medical debts to credit agencies. The approach aims not only at clearing past debts but also at preventing new ones through strengthened support systems.
Residents have started receiving notifications from individual hospitals confirming that their debts have been relieved; additionally, Undue Medical Debt has informed approximately 255,000 individuals about partial or full relief of their obligations.
North Carolina’s initiative began under former Governor Roy Cooper alongside then-NCDHHS Secretary Kody Kinsley. It remains unique nationwide for leveraging Medicaid programs toward comprehensive medical debt relief strategies. Governor Stein emphasized ongoing commitment: improving health outcomes by addressing social determinants of health, supporting preventive care access, reducing barriers within healthcare systems, and promoting community wellness remain priorities.
