All eligible North Carolina hospitals in debt relief plan

(The Center Square) – Gov. Roy Cooper announced on Monday that all 99 of the state’s eligible hospitals have agreed to participate in a medical relief program.

First announced on July 1, the program will forgive up to $4 billion in medical debt for as many as 2 million North Carolinians.

“Unlike most debts, medical debt is not a choice. People don’t choose to have accidents, cancer or heart attacks. This plan helps eliminate medical debt for low to moderate-income people in North Carolina,” Cooper, a Democrat, said in a statement .

He added that he believes this program will be critical for families.

“This first-in-the-nation program will make a difference in the lives of families across the state,” Cooper said.

Hospitals must opt into the program to receive an “enhanced level of payment” through the Healthcare Access and Stabilization Program, which was approved by lawmakers last year.

If any hospitals had declined , they would have just received a base level of payment for Medicaid reimbursement.

The hospitals are required to partner with organizations like Undue Medical Debt to “facilitate full implementation of medical debt relief over the next two years.”

This program, and the Medicaid expansion which was passed at the same time, will allow the state to draw more than $8 billion each year from the federal government.

Kody Kinsley, director of the state Department of Health and Human Services, applauded the program.

“Medical debt is a disease in our health system,” he posted to social media . “With all 99 hospitals committing to debt relief and improving charity care programs going forward, this is a huge win for patients and the health of North Carolina as a whole.”

Even while hospitals are opting into the program, there are still concerns about the hospital system across North Carolina.

A 2023 report from the state treasurer's office reported on the “extreme price markups” and lack of transparency in North Carolina hospitals.

“Widespread failures in price transparency have exposed North Carolinians to huge markups and extreme variations in hospital prices,” the report stated.

In some cases, hospitals in the state charge up to 12 times the amount of other hospitals, the report said.

Yet, the state is moving forward with the program, which will leverage “the state’s Medicaid program to encourage hospitals to relieve existing medical debt.”

Medicaid enrollees and other North Carolina citizens with incomes below 350% of the federal poverty level, or those with total medical debt owed to a participating hospital exceeding 5% of income, will begin having their debts paid off on Oct. 1. It will then continue for the next two years.

Eligible debts include ones at least two years old, dating back 10 years, and hospitals have until July 1 to forgive the debts of Medicaid enrollees.

Democratic candidate for governor Josh Stein has announced that he supports the program, which will likely require regular renewing.

“Medical debt is crippling. @NC_Governor’s plan represents a win-win, providing financial stability for hospitals and financial relief for North Carolinians,” Stein wrote on social media. “As Governor, I’ll continue this program and explore more opportunities to lower health care costs.”