As international students, there was an unspoken promise between us. If you need medical attention, don’t call an ambulance; call an Uber. reason? Fear of being billed for medical expenses that cannot be paid even with student insurance.
This fear stems from the unpredictability of hospital costs and the fact that patients often face unexpected out-of-pocket costs. Many of us find ourselves hesitant to see a doctor, delaying treatment, or not seeking treatment at all. Our reluctance was compounded by the ambiguity surrounding hospital funding and charity care (free or discounted care), and our failure to recognize the support that could have been available to ease the financial burden. This spurred me on even more.
This fear is not limited to international students. This is a widespread issue that impacts communities across the state, especially people of color and low-income communities. Black, Indigenous, Latino, and immigrant populations are disproportionately affected by medical debt because discrimination in employment and education affects their access to health insurance and other protections against medical debt. All of this exacerbates existing economic and health inequalities.
In Connecticut alone, approximately 280,000 people are unable to pay high medical bills and face financial ruin in a system that prioritizes profits over basic well-being. More than just a financial inconvenience, medical debt is a systemic problem rooted in disparities in income, wealth, and access to health care. Unlike planned debts such as a mortgage, medical debts often arise unexpectedly from his one-time medical expenses such as an accident or other medical emergency. Individuals who incur medical debt face reduced access to credit, an increased likelihood of bankruptcy, and the inability to cover basic needs such as food and rent. Additionally, they feel forced to forego necessary medical care to avoid incurring additional charges that they cannot afford.
Even more problematic is that even though the IRS requires nonprofit hospitals to provide hospital financial assistance, many eligible patients are unaware of these programs. As a result, they face lawsuits and harassment from collection agencies over bills that were supposed to be covered by hospital financial aid. In 2020, Connecticut hospitals spent $339 million less on financial aid and community investments compared to the tax breaks they receive as nonprofit hospitals. If this money had been used for financial aid, it could have eliminated medical debt for 240,612 residents.
A lack of accountability in implementing financial aid policies complicates the problem. Over the past decade, the IRS has not revoked a hospital’s nonprofit status for violations, leaving a regulatory void that states must fill to protect residents from unnecessary medical debt.
Addressing medical debt requires comprehensive solutions aimed at breaking the cycles that perpetuate it. Connecticut lawmakers must act.
We urge states and hospitals to work together to ensure that the most difficult moments of our lives do not leave us in dire financial straits. how? 1) Simplify the process for patients to learn about and access hospital financial aid through a streamlined application and robust notification system. 2) Preventing patients from being sent to collections before being reviewed for financial assistance and offering reasonable payment plans if ineligible. 3) Accept alternative documentation for patients to verify income to determine eligibility. 4) Hold hospitals accountable for ensuring fair testing processes and ending aggressive billing practices.
The first week of April, recognized by state law as Health Equity Week, is Connecticut’s annual effort to eliminate health disparities and create opportunities for all residents to be healthy and thrive. This year’s theme, “Ensuring Equity,” aims to remove economic barriers to equitable health outcomes for all residents.
As a community, we must confront the systemic injustices that perpetuate medical debt and impede access to health care. Implementing HB 5320 will move us closer to this goal. Looking back on my time as an international student, I believe that if I had had this kind of support system, I would not have had to sacrifice my health for financial stability.
By coming together in support of HB 5320, we can pave the way to a health care system where every individual can receive care without fear of financial devastation.
Ichchha Pradhan is a policy and advocacy specialist at Health Equity Solutions.