Yves here. The role of charity in addressing systemic issues often raises complex feelings, particularly when it substitutes for necessary legal or political reforms aimed at curbing abusive practices. Our discussions on medical debt date back several years, highlighting the disturbing tactics of predatory debt buyers who often attempt to collect on debts that are either far past the statute of limitations, disputed, or invalid due to improper transfers.
Take, for instance, Trinity Moravian Church in North Carolina, which spent a mere $17,000 to eliminate a staggering $2.2 million in medical debt, illustrating the corrupted nature of these debts.
These predatory debt buyers relentlessly pursue former patients with questionable bills. If the debtor does not contest the claim—perhaps simply by denying its legitimacy—the creditor can go to court and seek a default judgment. Defending against this often incurs significant legal costs, which many victims cannot afford.
While we should commend the grassroots efforts of Trinity Moravian Church, it’s crucial for them to expand their mission. They could collaborate with media and activist groups to make this kind of charity less necessary. It should become a criminal offense to sell medical debt that is either outside the statute of limitations or was improperly transferred. Both sellers and buyers should face severe penalties, including punitive damages for victims and reimbursement for legal fees. Furthermore, individuals involved, not just companies, should be held personally responsible. Holding executives criminally accountable may serve as a deterrent to such unethical practices.
By Noam N. Levey. Originally published at KFF Health News
The Rev. John Jackman, who leads Trinity Moravian Church in Winston-Salem, notes that their medical debt campaign has united people from different political backgrounds. “This is the easiest money I’ve ever raised,” he states. (Allison Lee Isley for KFF Health News)
Some hot-button issues, such as immigration and student loans, remain divisive even within Trinity Moravian Church.
“We have a wide range of political beliefs,” Rev. Jackman remarks about the church, which has been a staple in Winston-Salem for 114 years. Conservatives and liberals attend services side by side. Supporters of Donald Trump interact with his opponents. “It’s definitely a purple congregation,” he adds.
However, four years ago, Rev. Jackman proposed a new mission: to alleviate medical debt for local residents. This initiative faced no opposition. “This is the easiest money I’ve ever raised,” he recalls. “All I do is share our mission, and people respond generously.”
Healthcare has emerged as a particularly charged political issue, inciting fierce debates between Democrats and Republicans over matters such as the Affordable Care Act and Medicaid.
Yet, moved by the injustice of their neighbors’ medical debts, members of Trinity Moravian, regardless of their political affiliations, eagerly contributed $25 or $50 checks to help pay them off.
Their efforts have fueled a broader movement among churches across the state and even inspired North Carolina officials to confront the issue of medical debt head-on, earning praise from even conservative voices like radio host Glenn Beck.
This small church’s triumph has also revealed a shared concern across America: a growing anxiety and frustration with the medical debt crisis.
Earlier this year, Trinity completed its eighth medical debt campaign, part of the church’s Debt Jubilee Project, raising over $17,000. This generous sum allowed them to retire more than $2.2 million in medical debt. Because creditors expect most debts to go unpaid, medical debt can often be purchased at a fraction of its worth.
Across the nation, approximately 100 million adults are burdened with healthcare debt, with more than half of U.S. adults experiencing it at some point in their lives.
At Trinity Moravian Church, which has around 200 members, numerous stories of medical debt resonate among congregants.
“I witness people plunging into debt every minute of every day,” explains Catherine Coe, an employee in a hospital accounting department. “We’re all just one medical bill away from financial disaster.”
Coe grew up attending Trinity with her grandmother and returned to the church last year after drifting away in adulthood. A self-identified conservative, she supported Trump.
Terri Mabe, a longtime member of Trinity, has her own political convictions and has little patience for the current president, whom she claims shows a lack of concern for the American populace.
At 70, Mabe has firsthand experience with the harsh reality of medical debt from her years in the construction industry.
“During project downtimes, you often find yourself without work,” she reflects. “Then illness strikes, and suddenly you owe $5,000 or $10,000—amounts you can’t pay. You’re just managing your housing expenses, and then you’re left wondering: ‘What can I do now?’”
Both Coe and Mabe emphasize that political affiliations matter little in the face of medical debt. “There’s no political divide when it comes to medical debt,” Coe asserts. “It unites us all.”
Rev. Jackman conceived of the idea to address medical debt during the pandemic, as more individuals sought assistance from the church.
“I frequently heard stories of people unable to pay their electric bills due to overwhelming hospital invoices, creating a cycle of financial distress,” Jackman recalls. “These tales kept surfacing.”
He learned of a nonprofit named Undue Medical Debt that acquires unpaid medical bills from hospitals and collectors, allowing for their erasure.
The church’s initial campaign launched in 2022 aimed to raise $5,000 to eliminate approximately $500,000 in local medical debt. Remarkably, they met this goal within just six weeks, primarily through donations averaging less than $50.
Jackman, who has over 40 years of pastoral experience, attributes the initiative’s success to the church’s core values. “One of our principles is that while we may not fix every problem, we must address what we can within our community,” he explains.
Regardless of political views, church members share a common belief that the healthcare system is flawed and burdensome.
Paul Sluder, 78, a retired credit union employee, reflects on his extensive experience with debt collection.
Most individuals, he notes, wish to repay what they owe but may find themselves in unavoidable debt due to illness.
“You really have little control. You must care for yourself or your loved ones,” Sluder asserts. “It’s profoundly unfair, and the system is misguided.”
Polls indicate significant shared views regarding medical debt.
In a 2025 survey conducted for Undue Medical Debt, over 75% of both Republicans and Democrats expressed that collection agencies should not have the authority to garnish wages for medical debt. Recent bipartisan legislation aimed at enhancing protections against medical debt has seen acceptance in both blue and red states.
Coe, identifying as a Republican, advocates for stricter limits on medical debt burdens. “Why shouldn’t we establish a cap on medical debt, so that anything beyond that is either written off or forgiven?” she asks.
After concluding their latest debt cancellation campaign, Trinity held a special ceremony attended by local Scout troop members.
Rev. Jackman addressed the congregation, proudly displaying a list of names of county residents whose debts had been acquired and forgiven by the church.
“On this day of Jubilee,” Jackman proclaimed, “we forgive the debts of many of our neighbors just as God has forgiven ours.”
In a symbolic gesture, he lit a lighter and set fire to the list of 1,631 names. The flames transformed the paper into ashes as Scouts celebrated with confetti poppers and the choir sang, culminating in an exuberant cheer from the congregation.
Afterward, members enjoyed a spaghetti lunch in the church basement, served by the Scouts.
As they reflected on the celebratory day, many churchgoers expressed a desire for their work on medical debt to inspire others to overcome political differences and collaborate for change.
“There’s far too much division and anger,” observed Cynthia Tesh, 72.
“We need to take care of one another,” she urged. “If we start considering others instead of just ourselves, we can make a difference.”
