Lawmakers considering a bill requiring hospitals to write off or reduce patient debt
The Brief
The Affordable Care Act requires hospitals to adopt charity care policies, but many fail to inform patients about these options effectively.
Tamara Robinson faced a $30,000 medical bill after an eight-day hospital stay, despite having insurance, highlighting the issue of medical debt.
Jared Walker, founder of Dollar For, advocates for state laws to ensure hospitals screen patients for financial assistance programs before sending them to collections.
What we know
A federal law, the Affordable Care Act, mandates that most hospitals adopt charity care policies. However, many hospitals are reportedly failing to adequately inform patients about these options.
The backstory
In 2021, Tamara Robinson experienced severe insomnia due to COVID-19.
"I had severe insomnia; I didn't sleep for like a year and a half," she said. "That was the darkest time of my life. I've never been through anything like that, nor do I wish it on anyone."
Robinson's blood pressure spiked, leading to her immediate hospitalization. Her eight-day hospital stay was mostly covered by insurance, but she was left with a $30,000 bill.
"Thirty thousand dollars on a teacher's salary—I didn't know what I was going to do," Robinson said.
Medical debt is the leading cause of bankruptcy in the United States, with an estimated one in four patients avoiding care due to financial constraints.
"The nonprofit hospitals, which comprise most in America, are tax-exempt," said Jared Walker, founder and executive director of the nonprofit Dollar For.
"So the deal is they don't pay taxes, and in exchange, they will provide community benefit."
Walker argues that hospitals often fall short in delivering community benefits and do not consistently offer financial assistance policies to support low- to middle-income patients.
He advocates for a state law similar to the federal one, requiring hospitals to screen patients for these programs, particularly before sending them to collections.
"A law that requires hospitals to screen patients for these programs, especially before sending them to collections," Walker said. "Their credit is ruined, and it's all based off a bill that should have been waived or reduced in the first place."
For more information, visit DollarFor.org.
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USA Today
2 hours ago
- USA Today
'I refuse to give up': Michigan researchers, health officials grapple with funding cuts
'I refuse to give up': Michigan researchers, health officials grapple with funding cuts Show Caption Hide Caption Video: MSU breast cancer researcher Jamie Bernard talks about funding uncertainty MSU breast cancer researcher Jamie Bernard talks about federal funding uncertainty on Thursday, May 8, 2025, at her lab in East Lansing. Michigan public health officers say they've had to cut services and lay off workers after the Trump administration slashed funding, affecting their ability to work to stop the spread of disease. Scientists from the University of Michigan and Michigan State University say federal cuts to their research could halt development for new cancer treatments and eviscerate the scientific workforce. Using words like "devastating," "heartbreaking," and "shortsighted," Michigan public health leaders and researchers at the state's largest universities described the effects of President Donald Trump's efforts to slash federal government spending — through executive orders, cuts to federal grants, and stop work orders — and the wide-reaching fallout. Some local health departments have laid off workers and cut back on the services they can provide at regional laboratories and at community and in-school health clinics, and have seen disruptions in their ability to stop the spread of infectious disease, said Norm Hess, executive director of the Michigan Association for Local Public Health. When the U.S. Department of Health and Human Services revoked $11.4 billion in COVID-19-related grants in late March, the effects were felt across Michigan in ways that might not have been anticipated, he said. 'While everyone agrees the emergency response phase of COVID-19 is over, the funding streams created for pandemic response have been supporting laboratories monitoring other diseases around the state, from legionella to tuberculosis to measles, as well as water quality inspections and other sampling work,' Hess said. 'Federal leaders rescinded those grants, clearly thinking it was a responsible way to recover money that was being misspent. Instead, it's a great example of unintended consequences. Everyone agrees government should spend public dollars efficiently and effectively, but it appears they did not check to see what they were actually eliminating when cutting grants that had 'COVID' on the label.' Although Michigan Attorney General Dana Nessel has joined other states in challenging many of the Trump administration's cuts to federal public health and university research funding, including the $11.4 billion in COVID-19-related grants, Hess said it's too risky for local health departments to count on money that may or may not be awarded to them in the end. "You can't turn it off, and then if money comes, turn it back on," he said. Cuts hit research on the science of aging When he took office, Trump pledged to eliminate waste, fraud and abuse in federal spending, and "make America healthy again" by shifting priorities of the nation's top health agencies and taking aim at research and programs that focused on diversity, equity and inclusion. But medical researchers at Michigan State University and the University of Michigan say his administration's abrupt cuts to funding for scientific studies, clinical trials and training programs have all but gutted their life's work and could halt the development of new treatments for diseases like cancer as well as eviscerate the future scientific workforce. University of Michigan psychology professor Toni Antonucci lost the $13 million federal grant that supported her research on health disparities among aging Americans. It focused on minority populations, including African Americans, and comes at a moment in history when the U.S. population is older than it ever has been and is growing increasingly diverse. "I have never thought that politics should be involved in research, and, unfortunately, this is clearly the case here," said Antonucci, who has worked at U-M since the 1970s. "We were focusing on our most vulnerable populations, and I think that's the reason that the money was ... rescinded. "It shows a kind of shortsightedness and, in a way, vindictiveness. ... My focus was on ... how can the social relations that people have improve their health? What kinds of relationships are positive for people or negative for people? How do we increase the positive, and reduce the negative? "What are the kinds of things that universally predict better health, longer longevity? ... The point is, if you know what's influencing different groups, it gives you some insight on how to intervene both with that group and with other groups." Now, she said, that data will be lost. "If a government has policies that they want to enact, regardless of the data, then this is what you do," Antonucci said. "You just make sure there are no data. But just because you don't collect the data, that doesn't mean the association isn't still there." U-M professor: Slashed grants suggest 'you just don't matter' Gary Harper, a U-M professor of health behavior and health equity, learned in late March that his nearly $1.15 million five-year grant from the National Institutes of Health had been rescinded. "It's devastating," said Harper. "I am an openly gay man, and have been involved in activism, research, clinical work, and policy work in the HIV field for 40 years, starting out in 1985 as an old-time activist at a time when we were burying our friends every week. ... This is the first time in the history of my academic career that I've been without federal research or training funds." Harper is co-director of the SOAR at U-M, which stands for Student Opportunities for AIDS/HIV Research. It's a two-year intensive mentoring program that provides HIV-related research opportunities to undergraduate students, propelling them toward graduate school, and, eventually, the HIV research workforce. Many of those students are LGBTQ+ themselves, have disabilities, or come from low-income backgrounds, he said, but Harper noted that the program is open to anyone. "I'm a strong believer that we need to be making sure that we mentor researchers who reflect the communities that are most impacted," Harper said. More: Federal research cuts would rock Michigan economy, halt clinical trials, those affected say More: Trump's budget cuts could cost Michigan universities more than $200 million Discovering that the NIH canceled SOAR's grant funding "ripped me apart," Harper said. "We have one more cohort to get through their senior year." He said he won't let the Trump administration win and cancel the program before they graduate. "Basically, what they're saying is, 'We don't want to spend any money on you because you just don't matter,' " Harper said. " 'Your life has no value.' ... Well, I refuse to give up on them." Harper and SOAR's co-director are scrambling together the money themselves to pay for the final year of the program. Slowly, he said, that is coming together, but his other work through the Adolescent Medicine Trials Network (ATN) for HIV/AIDS Intervention has also been targeted by the federal cuts. A study on transgender youths was canceled, he said, and funding for the leadership group that oversees equity and inclusion in all ATN studies also was eliminated. He also lost grant funding to study gay and bisexual men in Kenya living with HIV. Still, he said, "I'm not going to let this get me down. "I try and show power and strength and resilience to the students, to give them hope that this, too, shall pass. This is a moment in time, but this is not your entire life. ... Your lives do matter. You are special and you are perfect, just the way you are." Breast cancer prevention studies in limbo The Trump administration isn't taking aim solely at research that fits its definition of DEI, said Jamie Bernard, an associate professor of pharmacology and toxicology at Michigan State University. "What I don't really think is being well communicated is that cancer research is also being threatened," said Bernard, who began studying interventions to prevent breast cancer in 2016, when her mother, Pamela O'Brien, was diagnosed with the disease at 61 years old. "This is something that Democrats and Republicans have always supported. In fact, we've come so far in the treatment of breast cancer due to federal funding, we diagnose women earlier. There's lots of options for treatment, and really, this research has saved a lot of lives and brought health care costs down." Her work is now focused on the environmental and lifestyle factors that can increase a woman's risk of getting aggressive breast cancers. "Not all breast cancers are curable, so that's what I really set off to focus on," she said, explaining that her work involves understanding how to kill cancer cells that are resistant to treatment and discovering new drug therapies. Earlier this year, she applied to renew a $2.07 million federal grant funded by the National Institutes of Health along with a new, $2.79 million grant, but both have been held up for months in a cloud of uncertainty. The initial reviews of her grants were postponed but eventually got through the first stage of the process; they now await the second step of review. There remain no guarantees. "How are they going to choose what they fund?" she said. "I don't know what's going to happen, really. So, we are in a time of uncertainty. Grant funding has always been uncertain. It's always been competitive, but there's always been a process and an infrastructure that researchers have relied on." Bernard runs a research lab at MSU, where a team of scientists are working to 'stop breast cancer from ever starting in the first place or prevent it so much that you've delayed it and you die of some other natural cause before you have to deal with cancer," she said. "I am in a place where I don't know if I should be accepting students in the fall. What's my next move? Am I still allowed to study what I've been studying? So it's a confusing time, a frustrating time, a time of high anxiety in our department of pharmacology and toxicology.' Bernard said the NIH canceled a grant for a graduate student from Puerto Rico who is Hispanic, and had applied through a mechanism that provided funding for predoctoral students who are disabled, identify as Black, Hispanic, American Indian or Alaska Native, or who are from socioeconomically disadvantaged backgrounds. "Just simply because she was a minority, the grant mechanism that she applied with, they withdrew it," Bernard said. "The white woman in my lab, her grant is going to be reviewed. ... It's so awful." The work they're doing, she said, "really should be bipartisan, nonpartisan — not even partisan. It's freaking cancer research." Ph.D. student reexamines future in scientific research The political climate is chasing Alex Chapman, a Ph.D. student at MSU who is studying migraines and pain, away from a career in academia. Chapman, 24, who is originally from Richmond, Virginia, secured a federal grant studying a neuropeptide that's upregulated in people with migraines, before Trump took office in January. Many of her friends and colleagues haven't been so lucky. "Science is being so vilified that I'm considering careers in other places or different avenues because it's just hard to see a future in a place that doesn't value science at all," she said. "It's heartbreaking. ... My career options are kind of dwindling, and the more time that passes, the more fellowships and different opportunities just keep becoming defunded," Chapman said, noting that a fellowship she was eyeing through the U.S. Agency for International Development (USAID) has been axed. She considered shifting toward public policy work, helping government leaders understand "why we should fund pain research," but then she attended a symposium and heard a woman who works in public policy speak about the cuts there, too. "She was like, 'This is a great fellowship. It's been defunded. This was an awesome fellowship. It's been defunded,' " Chapman said. When entrepreneur Elon Musk, who headed the new Department of Government Efficiency early in the Trump administration, criticized the use of federal dollars on scientific studies of legumes and aggression in hamsters, Chapman said, it showed that he couldn't see the full impact of the work. "If you just simplify it like that, maybe it does seem silly, but you're looking at the small picture," she said. "The point of research is to zoom out and look at the bigger picture. When you understand the best process of planting beans or why certain strains of corn are more susceptible to different fungi, you help people more effectively and efficiently plant food. This will help us in the face of climate change. "If you understand why a hamster is aggressive after ingesting a certain substance, you understand the role of that substance and how it could potentially affect humans." That small-picture view — and the cuts made because of it — could have generational impacts on the United States and the world, Chapman said. "This isn't just shutting down one study that focuses on hamsters fighting," she said. "It's preventing a new generation of scientists from coming into the (field), which is going to stunt our growth as a nation, which is going to prevent new ideas from happening, which is going to lead to ... horrible damage that would take years, if not decades, to recover. "People are afraid to come out and criticize this because of the way the government has treated them, especially foreign students. When it gets to the point where the government can strike fear in your heart if you speak out against them, especially about something regarding science, it's a very scary place to be." Local public health departments rattled, services cut Nick Derusha, the director and health officer of the LMAS District Health Department, which also includes Luce and Mackinac counties, said his part of the eastern Upper Peninsula has been rattled by a Trump administration stop-work order that means there's no money to run clinics that provide medicine like methadone to help people wean off opioid drugs and reduce the risk of overdose deaths in Alger and Schoolcraft counties. "We take a really holistic approach to that program," Derusha said. "We're not just providing medication-assisted treatment. We have peer recovery coaches. We have community health workers. We have a lot of staff that are there to support them in many other ways, not just the medication. "When funding is abruptly eliminated like that, we can't just drop people off the caseload. We needed to find a way for them to be able to continue to receive services or some type of off-ramp. We worked with the local hospital, and we agreed for three more months, which is kind of nearing the end here, to continue to provide those services, absent the funding. But the long-term ability of us to do that is not likely." In addition, Derusha said the LMAS department lost $512,000 a year to pay for a courier system for its laboratory services. Because the district is so sprawling — it covers four U.P. counties — when test samples need to be shipped to the regional lab in Luce County, ordinary mail often doesn't get them delivered quickly enough. Without the courier system, it means slower results for important public health testing, he said, which could delay treatments and lead to poorer outcomes. The LMAS District Health Department isn't alone. The Mid-Michigan Health Department, which includes Clinton, Gratiot and Montcalm counties, announced in April it will no longer investigate or treat latent tuberculosis infections because of "funding cuts and workforce limitations." Mental health services for school-age children are being cut, too, said Andrea Cole, president of the Ethel and James Flinn Foundation, a Detroit-based nonprofit dedicated to improving the quality, scope, and delivery of mental health services in Michigan. A $1 billion grant was terminated through the Department of Education in late April to pay for in-school social workers, counselors and other mental health professionals — even though 70% of children who receive mental health services get them through their schools, she said. "A lot of the federal cuts were to the most vulnerable and underserved populations," Cole said. "Schools are faced with the possibility of laying off those people that they hired under that grant if they don't have funding to continue it." And the students will be left without that critical mental health support when "they need it more than ever," Cole said. Hess said all of these cuts, along with proposed legislation — the Big, Beautiful Bill Act, which has passed the U.S. House of Representatives and now is under consideration in the U.S. Senate — that would slash Medicaid and Supplemental Nutrition Assistance Program (SNAP) benefits, and a state Senate budget proposal that also seeks to trim funding even more, public health in Michigan could dramatically change. More: Whitmer: Trump's 'big, beautiful bill' could cost Michigan $900 million a year for food stamps More: 700,000 Michigan residents could lose health insurance under Medicaid cuts, report shows "We don't want to give the impression that the sky is falling, and that public health is going to pack up and go home," Hess said. "We've been here for 100 years, and we've seen ups and downs over the years. Health officers are used to kind of making things work, but this is sort of a unique situation. "Community residents are really going to feel this if all of these things that we are watching come to fruition. Public health will not look the same in their communities, in most places." Contact Kristen Shamus: kshamus@ Subscribe to the Detroit Free Press.
The Hill
21 hours ago
- The Hill
Hundreds of pharmacies are set to close: How it could impact you
(NEXSTAR) — Several retail pharmacy chains have shuttered some of their stores this year, with more on the way for others, like Rite Aid, which filed for bankruptcy in May. It could create what some refer to as 'pharmacy deserts,' areas in which drugstores and the additional services they provide may not be available for miles. And in areas where other pharmacies are picking up the slack, it could have an impact on current customers. 'Closures of major chain pharmacies often create ripple effects across the community,' E. Michael Murphy, an assistant professor of clinical pharmacy at The Ohio State University, told Nexstar via email. Nearby pharmacies, independent or part of a chain, can see 'a sudden increase in patients,' he explained, which could 'lead to longer lines, and increase strain on the health care team.' It could also disrupt your medical care. Shuttering pharmacies in larger cities, like New York City and Philadelphia, may have limited impacts. Take, for example, a Rite Aid located in Philadelphia that has been designated for closure. A three-minute walk down the road will take you to a Walgreens and a local pharmacy. Within smaller communities, that may not be the case. Customers may need to drive to a nearby town to pick up their prescriptions, which 'could have some negative consequences on their adherence to their medication,' Lucas A. Berenbrok, an associate professor at the University of Pittsburgh School of Pharmacy, explained to Nexstar. 'For those without reliable transportation, especially older adults or people with disabilities, traveling even a few extra miles can be a serious barrier,' Murphy said. That could lead to delayed access to prescriptions and missed dosages. Closing pharmacies also reduces health access points for people. In addition to filling prescriptions, pharmacies are able to provide vaccines, chronic disease management, urgent consultations, over-the-counter treatments, and certain health tests. 'There's a lot more going on at the pharmacy now than ever before,' Berenbrok explained, outlining how pharmacists helped to administer the COVID vaccine during the pandemic, for example, and the additional services they can provide in some states. He went on to explain that while online pharmacies can help fill the void of shuttered drugstores, they're largely unable to accommodate the additional services pharmacies provide. 'They also assume reliable internet access, digital literacy, and stable housing, which are barriers for many vulnerable patients,' Murphy said. 'For communities losing local pharmacies, online options may fill part of the gap but cannot replace the full range of services a community pharmacist provides.' Berenbrok agreed that mail-order pharmacies have 'a time and place' because of their convenience, but they require planning ahead, which may not be useful for certain medications like antibiotics. If your pharmacy is closing soon, Murphy recommended being proactive and asking your pharmacist where your prescriptions are being sent and whether that pharmacy has your insurance and medication history. He also encouraged asking for a 90-day supply or mail-order option for prescriptions if transportation is a concern. Chains poised to take on former Rite Aid clients, like CVS and Walgreens, say they're prepared to welcome new customers. Even if your prescriptions are not moving to a new pharmacy, you may want to make sure your prescription is being filled a day or two before you need it rather than the same day that your current supply runs out, Berenbrok said. Then, if you're short on time and facing a long line, you won't miss a dose. Murphy also suggested contacting elected officials and urging them to take action. 'While pharmacists are committed to stepping up to meet the need, without adequate state and federal policy changes to address the broken business model that caused the pharmacy to close in the first place, we will continue to see pharmacies close and patients having to navigate the loss of their trusted health care professional.'
Yahoo
a day ago
- Yahoo
In Lansing, Democrats warn Medicaid and SNAP cuts would be a 'perfect storm' for the poor
U.S. Sen. Elissa Slotkin (D-Holly) and U.S. Rep. Kristen McDonald Rivet (D-Bay City) at a June 6, 2025 town hall in Lansing. | Kyle Davidson Members of the Michigan Democratic Party laid out the impacts of congressional Republicans' 'big beautiful bill' at a town hall on Friday, calling on residents of Michigan's 7th Congressional District to help educate their friends and family as well. A few hundred supporters packed into the gym of Everett High School in Lansing as U.S. Sen. Elissa Slotkin (D-Holly), U.S. Rep. Kristen McDonald Rivet (D-Bay City) and Michigan Democratic Party Chair Curtis Hertel detailed how the Trump administration's policies would impact everyone, particularly individuals with limited income. The Michigan Democratic Party has hosted several similar events in Republican districts throughout the state, Hertel said, noting House Republicans had been instructed to avoid town halls with their constituents. 'The most basic thing for a public servant is to be able to sit and answer questions. … The least someone can do is sit down with people and explain their votes' Hertel said. And the 7th Congressional District's current representative, Tom Barrett (R-Charlotte) has a lot of explaining to do, Hertel said, slamming Barrett for supporting Republican's spending plan, and arguing the representative failed to stand up to the President and make himself available to his constituents A Barrett spokesperson did not respond to a request for comment. Prior to taking questions, McDonald Rivet slammed the Republican spending effort, telling audience members that it would take away healthcare and raise the cost of medicine, education and energy in order to deliver a tax break to the wealthy. 'Oh, and by the way, it's going to increase the deficit by several trillion dollars,' She said. Slotkin looked back on the president's first term, when Trump was looking to overturn the Affordable Care Act, which expanded access to Medicaid and barred insurance providers from denying people coverage or charging them due to preexisting health conditions. 'It was the first thing he talked about when he got sworn in, he even had the House of Representatives vote to repeal Obamacare. And now we not only still have it, we expanded it, and how? Because we educated people,' Slotkin said. However, rather than cutting people's healthcare outright, Slotkin argued Trump is aiming to hide those cuts by requiring individuals to reregister for Medicaid every six months, making it harder to qualify and more difficult to sign up. While the current proposal would implement work requirements for Medicaid recipients, Slotkin noted it also raises the age limit for those requirements to 64. According to KFF, an independent health policy organization, 92% of medicaid recipients under 65 are already working full or part time. The nonpartisan Congressional Budget Office estimated that Republican's budget plan would result in 10.9 million additional people being uninsured in 2034, with 7.8 million fewer individuals on Medicaid due to the policy's proposed work requirements. Even individuals who are not on Medicaid will feel the impacts of cuts to the program, Slotkin said, noting that nursing homes, hospitals and mental health facilities all rely on Medicaid funding. 'I would just say this bill is designed to really be a perfect storm for poor people. If you are living at or below the poverty line, you're getting hit in every direction. Medicaid, your health care; SNAP your food; a bunch of programs, right, that you depend on. … They are paying for those tax benefits for the most wealthy by really the perfect storm of cuts for the poorest among us,' Slotkin said. On top of cutting SNAP benefits by $300 billion, the Department of Government Efficiency had canceled $1 billion in funding to programs supporting school meals and food banks, McDonald Rivet said. 'So you're that hungry kid and you have lost access to a food bank. You have lost access to food at school, and now you don't have SNAP benefits. This is the America that this bill creates,' McDonald Rivet said. Alongside questions on cuts to SNAP and Medicaid, audience members asked the lawmakers about the legal challenges levied against the Trump administration, and Democrats' plans to counter Republicans heading into the 2026 mid-term election. On Friday, the Trump Administration backed down in its resistance of a Supreme Court order demanding that the administration facilitate the return of Kilmar Abrego Garcia, who was wrongly deported to El Salvador three months ago. However, the fight goes beyond Abrego Gracia, into whether the executive branch needs to obey orders from the Supreme Court, Slotkin said. 'Now, we haven't had to deal with this issue in the years past because Democrats and Republicans have largely said, 'Huh, if the Chief Justice of the Supreme Court issues a court order, we're going to follow it.' Trump is pushing the boundaries on all the democratic values and principles most of us grew up with,' Slotkin said. Should an individual defy a federal court order, U.S. marshals would eventually be sent to enforce that order, Slotkin said. However, the U.S. marshals are controlled by the United States attorney general. Should the U.S. marshals receive a request to enforce a Supreme Court order against the president, Slotkin raised the question on whether Attorney General Pam Bondi, a Trump loyalist, would approve it. 'We've needed to have this fight. We need to have it out. We need a court order that he needs to obey, and we need to precipitate this conversation on the U.S. marshals. But today was an important sign that they don't want to get to that point. They don't want to wait until the U.S. marshals are potentially getting an order to activate,' Slotkin said. In preparing to take on the Trump Administration, Slotkin said she'd gone back to her roots in national security and crafted a war plan in the form of a 17-page powerpoint, with plans to lay out her vision of the nation's future under Democratic leadership. 'It's about facing our problems head on and saying the only way we do well as a country, the only way that we have a strong middle class going forward, the American Dream going forward, is if we face these issues and have a vision. And it's economic, it's about national security, and it's about our democracy,' Slotkin said. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
