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Medical Debt in California: As Permanent Solutions Take Root, Blacks Remain Hardest Hit

On June 26, the Los Angeles County Board of Supervisors approved a $5 million pilot program to eliminate up to $500 million in medical debt owed by an estimated 150,000 residents. The funds will be used for an agreement with Undue Medical Debt, a non-profit organization that buys unpaid debt at a fraction of its original cost and absolves it. The effort is expected to launch later this year. The initiative, authored by Supervisors Holly Mitchell and Janice Hahn, intends to eventually buy a total of $2.9 billion in medical debt, impacting some 800,000 L.A. County residents.  

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Russell Stiger, California Black Media
Russell Stiger, California Black Media.

By Edward Henderson California Black Media  

On June 11, Vice President Kamala Harris and Consumer Financial Protection Bureau Director (CFPB) Rohit Chopra announced that the Biden administration has established a new federal rule that removes medical debt from the credit reports of nearly 15 million Americans. The rule also bans reporting agencies from factoring that debt into credit scores.

“We are making it so that medical debt cannot be used against you when you apply for a car loan, a home loan, or a small-business loan,” said the Vice President.

“Millions of Americans will see an increase in their credit score, on average, of 20 points, which will mean every year an estimated 22,000 more American families will be approved for a mortgage and able to buy a home,” she added.

On June 26, the Los Angeles County Board of Supervisors approved a $5 million pilot program to eliminate up to $500 million in medical debt owed by an estimated 150,000 residents. The funds will be used for an agreement with Undue Medical Debt, a non-profit organization that buys unpaid debt at a fraction of its original cost and absolves it. The effort is expected to launch later this year. The initiative, authored by Supervisors Holly Mitchell and Janice Hahn, intends to eventually buy a total of $2.9 billion in medical debt, impacting some 800,000 L.A. County residents.

The federal government and Los Angeles County are not alone in trying to find permanent solutions to the worrisome problem of medical debt. Policymakers and advocates in California and around the country have been proposing a range of solutions to address the escalating problem of medical debt, which burdens people at all income levels, but falls especially hard on middle-class Black people.

In 2020, nearly 23.5% of Americans earning between $50,000 and $100,000 had medical debt that they could not afford to pay according to a study by Third Way, a Washington-D.C.-based think tank.

For African Americans, the numbers are particularly concerning. About 38% of Black Americans have accrued medical debt they can’t afford to pay.

“Medical debt is more than a financial burden; it is a profound health crisis that disproportionately impacts Black Californians, stripping them of economic security and mental peace, perpetuating a cycle of economic insecurity and health disparities in communities already vulnerable,” states Kellie Todd Griffin, President & CEO of California Black Women’s Collective Empowerment Institute.

Why do Black people have so much more medical debt than their White peers? Researchers from the National Consumer Law Center point to both the racial wealth gap and the racial health gap. In their 2022 report on medical debt, they found that “racial inequality underlies these disparities in medical debt.” Without equal opportunities to earn, save and build wealth through homeownership, Black people are less able to pay their medical bills, which leaves them unable to get medical care. This leads to a spiral of debt and poor health.”

According to the California Reparations Report, in 2019, the median African American household had a net worth of $24,100 as compared to the median net worth of white households of $188,200.

According to the report, “This wealth gap persists regardless of education level and family structure.”

Consider the case of Bethany Harris, a Black, middle-class resident of San Diego.

When excruciating back pain drove Harris to seek medical attention, she had no idea that doctors would admit her and recommend gallbladder surgery. She ended up spending three days in the hospital.

Despite having a stable professional job and employer-provided health, Harris was shocked to receive a $4,500 co-pay for her initial care and tests. A year later, the surgery added another $6,500 in co-pay responsibility.

“The co-pay is ridiculous,” Harris told California Black Media. I have been spending all this money out of my paycheck for 20 years for insurance. I barely use it outside of annual physicals and eyeglasses. It’s crazy, there is no way I can afford this stuff.”

For middle-class Black Californians like Harris, their income level often disqualifies them from most institutional discounts, government financial assistance, and nonprofit assistance.

Rhonda Smith, Executive Director of the California Black Health Network (CBHN), told California Black Media, “People with medical debt absolutely have rights.”

“California requires hospitals to provide financial aid to patients.” Download your hospital’s financial aid policy. You can get the policies and applications in the state on the California Department of Health Access and Information (HCAI) website.”

Dr. Naman Shah is a family physician and epidemiologist at the LA Department of Public Health, where he is Director for the Division of Medical and Dental Affairs.

Shah mentioned some of the other pitfalls that can plunge individuals further into debt, including medical credit cards and dubious or unclear billing methods employed by some hospitals. In addition, debt collections agencies will apply unscrupulous methods and, according to a study by ProPublica, disproportionately target Black communities.

A range of policies and programs to address medical debt are in motion across the country and here in California. In January 2024, New York City Mayor Eric Adams approved $18 million to purchase the medical debt of 500,000 New Yorkers, saving them up to $2 billion.

In March, state Attorney General Rob Bonta, Senator Monique Limón (D- Santa Barbara), and a coalition of prominent consumer advocacy organizations unveiled Senate Bill 1061 (SB 1061), legislation seeking to protect the financial security of Californians by prohibiting medical debt from being listed on credit reports.

Before Harris announced the White House rule, U.S. Senators Bernie Sanders (D-VT.) and Jeff Merkley (D-OR.) and U.S. Rep. Ro Khanna (D-CA-17) introduced legislation in May to cancel some $220 billion in medical debt owed by Americans across the country.

“This is the United States of America, the richest country in the history of the world. People in our country should not be going bankrupt because they got cancer and could not afford to pay their medical bills,” said Sanders.  “The time has come to cancel all medical debt and guarantee health care to all as a human right, not a privilege.”

This article is supported by the California Black Health Journalism Project, a program created by California Black Media, that addresses the top health challenges African Americans in California face. It relies on the input of community and practitioners; an awareness of historical factors, social contexts and root causes; and a strong focus on solutions as determined by policymakers, advocates and patients.

Activism

Oakland Post: Week of June 18 – 24, 2025

The printed Weekly Edition of the Oakland Post: Week of June 18 – 24, 2025

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Juneteenth: Celebrating Our History, Honoring Our Shared Spaces

It’s been empowering to watch Juneteenth blossom into a widely celebrated holiday, filled with vibrant outdoor events like cookouts, festivals, parades, and more. It’s inspiring to see the community embrace our history—showing up in droves to celebrate freedom, a freedom delayed for some enslaved Americans more than two years after the Emancipation Proclamation was signed.

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Wayne Wilson, Public Affairs Campaign Manager, Caltrans
Wayne Wilson, Public Affairs Campaign Manager, Caltrans

By Wayne Wilson, Public Affairs Campaign Manager, Caltrans

Juneteenth marks an important moment in our shared history—a time to reflect on the legacy of our ancestors who, even in the face of injustice, chose freedom, unity, and community over fear, anger, and hopelessness. We honor their resilience and the paths they paved so future generations can continue to walk with pride.

It’s been empowering to watch Juneteenth blossom into a widely celebrated holiday, filled with vibrant outdoor events like cookouts, festivals, parades, and more. It’s inspiring to see the community embrace our history—showing up in droves to celebrate freedom, a freedom delayed for some enslaved Americans more than two years after the Emancipation Proclamation was signed.

As we head into the weekend full of festivities and summer celebrations, I want to offer a friendly reminder about who is not invited to the cookout: litter.

At Clean California, we believe the places where we gather—parks, parade routes, street corners, and church lots—should reflect the pride and beauty of the people who fill them. Our mission is to restore and beautify public spaces, transforming areas impacted by trash and neglect into spaces that reflect the strength and spirit of the communities who use them.

Too often, after the music fades and the grills cool, our public spaces are left littered with trash. Just as our ancestors took pride in their communities, we honor their legacy when we clean up after ourselves, teach our children to do the same, and care for our shared spaces.

Small acts can inspire big change. Since 2021, Clean California and its partners have collected and removed over 2.9 million cubic yards of litter. We did this by partnering with local nonprofits and community organizations to organize grassroots cleanup events and beautification projects across California.

Now, we invite all California communities to continue the incredible momentum and take the pledge toward building a cleaner community through our Clean California Community Designation Program. This recognizes cities and neighborhoods committed to long-term cleanliness and civic pride.

This Juneteenth, let’s not only celebrate our history—but also contribute to its legacy. By picking up after ourselves and by leaving no litter behind after celebrations, we have an opportunity to honor our past and shape a cleaner, safer, more vibrant future.

Visit CleanCA.com to learn more about Clean California.

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Activism

OPINION: California’s Legislature Has the Wrong Prescription for the Affordability Crisis — Gov. Newsom’s Plan Hits the Mark

Last month, Gov. Newsom included measures in his budget that would encourage greater transparency, accountability, and affordability across the prescription drug supply chain. His plan would deliver real relief to struggling Californians. It would also help expose the hidden markups and practices by big drug companies that push the prices of prescription drugs higher and higher. The legislature should follow the Governor’s lead and embrace sensible, fair regulations that will not raise the cost of medications.

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Rev. Dr. Lawrence E. VanHook. Courtesy of Rev. Dr. Lawrence E. VanHook.
Rev. Dr. Lawrence E. VanHook. Courtesy of Rev. Dr. Lawrence E. VanHook.

By Rev. Dr. Lawrence E. VanHook

As a pastor and East Bay resident, I see firsthand how my community struggles with the rising cost of everyday living. A fellow pastor in Oakland recently told me he cuts his pills in half to make them last longer because of the crushing costs of drugs.

Meanwhile, community members are contending with skyrocketing grocery prices and a lack of affordable healthcare options, while businesses are being forced to close their doors.

Our community is hurting. Things have to change.

The most pressing issue that demands our leaders’ attention is rising healthcare costs, and particularly the rising cost of medications. Annual prescription drug costs in California have spiked by nearly 50% since 2018, from $9.1 billion to $13.6 billion.

Last month, Gov. Newsom included measures in his budget that would encourage greater transparency, accountability, and affordability across the prescription drug supply chain. His plan would deliver real relief to struggling Californians. It would also help expose the hidden markups and practices by big drug companies that push the prices of prescription drugs higher and higher. The legislature should follow the Governor’s lead and embrace sensible, fair regulations that will not raise the cost of medications.

Some lawmakers, however, have advanced legislation that would drive up healthcare costs and set communities like mine back further.

I’m particularly concerned with Senate Bill (SB) 41, sponsored by Sen. Scott Wiener (D-San Francisco), a carbon copy of a 2024 bill that I strongly opposed and Gov. Newsom rightly vetoed. This bill would impose significant healthcare costs on patients, small businesses, and working families, while allowing big drug companies to increase their profits.

SB 41 would impose a new $10.05 pharmacy fee for every prescription filled in California. This new fee, which would apply to millions of Californians, is roughly five times higher than the current average of $2.

For example, a Bay Area family with five monthly prescriptions would be forced to shoulder about $500 more in annual health costs. If a small business covers 25 employees, each with four prescription fills per month (the national average), that would add nearly $10,000 per year in health care costs.

This bill would also restrict how health plan sponsors — like employers, unions, state plans, Medicare, and Medicaid — partner with pharmacy benefit managers (PBMs) to negotiate against big drug companies and deliver the lowest possible costs for employees and members. By mandating a flat fee for pharmacy benefit services, this misguided legislation would undercut your health plan’s ability to drive down costs while handing more profits to pharmaceutical manufacturers.

This bill would also endanger patients by eliminating safety requirements for pharmacies that dispense complex and costly specialty medications. Additionally, it would restrict home delivery for prescriptions, a convenient and affordable service that many families rely on.

Instead of repeating the same tired plan laid out in the big pharma-backed playbook, lawmakers should embrace Newsom’s transparency-first approach and prioritize our communities.

Let’s urge our state legislators to reject policies like SB 41 that would make a difficult situation even worse for communities like ours.

About the Author

Rev. Dr. VanHook is the founder and pastor of The Community Church in Oakland and the founder of The Charis House, a re-entry facility for men recovering from alcohol and drug abuse.

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