Each year 22,000 lawsuits are filed against Utahns with medical debt — a figure that makes up around a third of all Utah debt collection cases.
Medical debt is not an issue unique to Utah; in fact, a 2022 national survey on health care debt found that 100 million Americans are saddled with medical debt. Over half of U.S. adults reported going into debt in the last few years because of medical and dental bills. One in five of those with health care debt said they don’t expect to ever pay it off, and a quarter owed over $5,000.
A Utah nonprofit hopes to help lower the statistics. Holy Cross Ministries Medical Debt Legal Advice Program helps individuals navigate what can often be a confusing and overwhelming process.
“This program is pretty much going to be helping these individuals to kind of alleviate some of that debt by just understanding what they can do and what their options are and then also having a person that’s going to be available for them to help them through that process — because most of the time, they don’t get anyone to help them or explain to them what is going on,” said Carmen Cardenas, a medical debt legal advocate with Holy Cross Ministries.
The advocates who work with the nonprofit speak both English and Spanish and are trained to give legal advice about how to resolve medical debt. The program is free of cost and open to individuals regardless of their legal status or the amount of their debt. Cardenas, for example, has helped individuals with medical debt ranging from $80 to $297,000.
“It’s actually a pilot. It’s the first of its kind in the whole country,” said Carlos Flores, health outreach program manager with Holy Cross.
The program is part of the Innovation for Justice Program, a cross-jurisdictional legal innovation lab that is housed at both the University of Arizona James E. Rogers College of Law and the University of Utah Eccles School of Business.
The Utah Supreme Court approved the Medical Debt Legal Advice Program as part of the state’s regulatory sandbox, which seeks to knock down barriers to legal justice by providing a space for lawyers and other professionals to deliver nontraditional legal services. Although the advocates can offer legal advice, they cannot represent people in court. The Utah Supreme Court also approved a medical debt diversion plan to train medical debt legal advocates at two Salt Lake City nonprofits: the AAA Fair Credit Foundation and People’s Legal Aid.
Although the Holy Cross Ministries program is new, it builds upon similar work the nonprofit was already doing. Cardenas is currently the nonprofit’s only trained medical debt legal advocate, but its short-term plan is to train two more.
Cardenas spent a year as a community health worker before being trained as medical debt legal advocate. During that time, she saw individuals and families of a variety of ages and circumstances experiencing medical debt.
“We have everything and everybody across the board,” she said. “We help anybody who walks through our doors. To us, it makes no difference, their immigration status. We see every individual. We’re all human beings. Everybody has to eat. Everybody gets sick.”
She added that navigating the process can be even more difficult for undocumented families who don’t qualify for many types of health insurance.
“Many of them are hiding under the radar. They’re stuck, kind of in limbo, because they’re trying to get the legal process going. Meanwhile, they have to eat, their children have to eat, so they’re trying to do the best they can,” she said. “A lot of times there’s many barriers and that’s pretty much the reason for the Innovation for Justice (Program). They’re trying to find ways to break those barriers and have equality, diversity and inclusion.”
Cardenas warns those she works with that their medical debt won’t disappear overnight and the process takes a lot of patience and investigation. Holy Cross could not say how many Utahns it might be able to help through the program, because each case is so unique.
Regardless of the details of each case, Cardenas said the work is rewarding.
One of her recent clients contacted Holy Cross Ministries for help with medical debt. Upon meeting with the woman, Cardenas learned that she had fled her home country after her father was killed and she feared for her safety. The medical debt stemmed from a hospital visit for her 1-year-old son. Because the mother and son are undocumented, neither had medical benefits or insurance. Cardenas helped the mother navigate her medical debt and get in touch with legal immigration services.
“Yes, they may come to us for medical debt. But then, as you’re talking to them, you hear you hear stories about what they have experienced and what they’ve gone through,” she said. “And that’s why I feel so good, because if they wouldn’t have contacted me, then I wouldn’t be able to do a referral within our agency with other things that we offer because we do have wraparound services.”