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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 May 21 – 27, 2025

The printed Weekly Edition of the Oakland Post: Week of May 21 – 27, 2025

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OPINION: Your Voice and Vote Impact the Quality of Your Health Care

One of the most dangerous developments we’re seeing now? Deep federal cuts are being proposed to Medicaid, the life-saving health insurance program that covers nearly 80 million lower-income individuals nationwide. That is approximately 15 million Californians and about 1 million of the state’s nearly 3 million Black Californians who are at risk of losing their healthcare. 

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Rhonda M. Smith.
Rhonda M. Smith.

By Rhonda M. Smith, Special to California Black Media Partners

Shortly after last year’s election, I hopped into a Lyft and struck up a conversation with the driver. As we talked, the topic inevitably turned to politics. He confidently told me that he didn’t vote — not because he supported Donald Trump, but because he didn’t like Kamala Harris’ résumé. When I asked what exactly he didn’t like, he couldn’t specifically articulate his dislike or point to anything specific. In his words, he “just didn’t like her résumé.”

That moment really hit hard for me. As a Black woman, I’ve lived through enough election cycles to recognize how often uncertainty, misinformation, or political apathy keep people from voting, especially Black voters whose voices are historically left out of the conversation and whose health, economic security, and opportunities are directly impacted by the individual elected to office, and the legislative branches and political parties that push forth their agenda.

That conversation with the Lyft driver reflects a troubling surge in fear-driven politics across our country. We’ve seen White House executive orders gut federal programs meant to help our most vulnerable populations and policies that systematically exclude or harm Black and underserved communities.

One of the most dangerous developments we’re seeing now? Deep federal cuts are being proposed to Medicaid, the life-saving health insurance program that covers nearly 80 million lower-income individuals nationwide. That is approximately 15 million Californians and about 1 million of the state’s nearly 3 million Black Californians who are at risk of losing their healthcare.

Medicaid, called Medi-Cal in California, doesn’t just cover care. It protects individuals and families from medical debt, keeps rural hospitals open, creates jobs, and helps our communities thrive. Simply put; Medicaid is a lifeline for 1 in 5 Black Americans. For many, it’s the only thing standing between them and a medical emergency they can’t afford, especially with the skyrocketing costs of health care. The proposed cuts mean up to 7.2 million Black Americans could lose their healthcare coverage, making it harder for them to receive timely, life-saving care. Cuts to Medicaid would also result in fewer prenatal visits, delayed cancer screenings, unfilled prescriptions, and closures of community clinics. When healthcare is inaccessible or unaffordable, it doesn’t just harm individuals, it weakens entire communities and widens inequities.

The reality is Black Americans already face disproportionately higher rates of poorer health outcomes. Our life expectancy is nearly five years shorter in comparison to White Americans. Black pregnant people are 3.6 times more likely to die during pregnancy or postpartum than their white counterparts.

These policies don’t happen in a vacuum. They are determined by who holds power and who shows up to vote. Showing up amplifies our voices. Taking action and exercising our right to vote is how we express our power.

I urge you to start today. Call your representatives, on both sides of the aisle, and demand they protect Medicaid (Medi-Cal), the Affordable Care Act (Covered CA), and access to food assistance programs, maternal health resources, mental health services, and protect our basic freedoms and human rights. Stay informed, talk to your neighbors and register to vote.

About the Author

Rhonda M. Smith is the Executive Director of the California Black Health Network, a statewide nonprofit dedicated to advancing health equity for all Black Californians.

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Activism

OPINION: Supreme Court Case Highlights Clash Between Parental Rights and Progressive Indoctrination

At the center of this controversy are some parents from Montgomery County in Maryland, who assert a fundamental principle: the right to shield their children from exposure to sexual content that is inappropriate for their age, while also steering their moral and ethical upbringing in alignment with their faith. The local school board decided to introduce a curriculum that includes LGBTQ+ themes — often embracing controversial discussions of human sexuality and gender identity.

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Craig J. DeLuz. Courtesy of Craig J. DeLuz.
Craig J. DeLuz. Courtesy of Craig J. DeLuz.

By Craig J. DeLuz, Special to California Black Media Partners

In America’s schools, the tension between parental rights and learning curricula has created a contentious battlefield.

In this debate, it is essential to recognize that parents are, first and foremost, their children’s primary educators. When they send their children to school — public or private — they do not surrender their rights or responsibilities. Yet, the education establishment has been increasingly encroaching on this vital paradigm.

A case recently argued before the Supreme Court regarding Maryland parents’ rights to opt out of lessons that infringe upon their religious beliefs epitomizes this growing conflict. This case, Mahmoud v. Taylor, is not simply about retreating from progressive educational mandates. It is fundamentally a defense of First Amendment rights, a defense of parents’ rights to be parents.

At the center of this controversy are some parents from Montgomery County in Maryland, who assert a fundamental principle: the right to shield their children from exposure to sexual content that is inappropriate for their age, while also steering their moral and ethical upbringing in alignment with their faith. The local school board decided to introduce a curriculum that includes LGBTQ+ themes, often embracing controversial discussions of human sexuality and gender identity. The parents argue that the subject matter is age-inappropriate, and the school board does not give parents the option to withdraw their children when those lessons are taught.

This case raises profound questions about the role of public education in a democratic society. In their fervent quest for inclusivity, some educators seem to have overlooked an essential truth: that the promotion of inclusivity should never infringe upon parental rights and the deeply held convictions that guide families of different faith backgrounds.

This matter goes well beyond mere exposure. It veers into indoctrination when children are repeatedly confronted with concepts that clash with their family values. 

“I don’t think anybody can read that and say: well, this is just telling children that there are occasions when men marry other men,” noted Justice Samuel Alito. “It has a clear moral message, and it may be a good message. It’s just a message that a lot of religious people disagree with.”

Justice Amy Coney Barrett raised a crucial point, noting that it is one thing to merely expose students to diverse ideas; it is quite another to present certain viewpoints as indisputable truths. By framing an ideology with the certainty of “this is the right view of the world,” educators risk indoctrination rather than enlightenment. This distinction is not merely academic; it speaks to the very essence of cultivating a truly informed citizenry.

Even Justice Elena Kagan expressed concern regarding the exposure of young children to certain materials in Montgomery County.

“I, too, was struck by these young kids’ picture books and, on matters concerning sexuality, I suspect there are a lot of non-religious parents who weren’t all that thrilled about this,” she said.

Justice John Roberts aptly questioned the practicality of expecting young children to compartmentalize their beliefs in the classroom.

“It is unreasonable to expect five-year-olds, still forming their worldviews, to reconcile lessons that conflict fundamentally with the teachings they receive at home,” he said.

As was noted in my previous commentary, “The Hidden Truth In The Battle Over Books In American Schools”, what lies at the heart of these debates is a moral disconnect between the values held by the majority of Americans and those promoted by the educational establishment. While the majority rightly argue that material containing controversial content of a sexual nature should have no place in our children’s classrooms, the education establishment continues to tout the necessity of exposing children to such content under the guise of inclusivity. This disregards the legitimate values held by the wider community.

Highlighted in this case that is before the Supreme Court is a crucial truth: parents must resolutely maintain their right to direct their children’s education, according to their values. This struggle is not simply a skirmish; it reflects a broader movement aimed at reshaping education by privileging a state-sanctioned narrative while marginalizing dissenting voices.

It is imperative that we assert, without hesitation, that parents are — and must remain — the primary educators of their children.

When parents enroll a child in a school, it should in no way be interpreted as a relinquishment of parental authority or the moral guidance essential to their upbringing. We must stand firm in defending parental rights against the encroaching ideologies of the education establishment.

About the Author

Craig J. DeLuz has almost 30 years of experience in public policy and advocacy. He has served as a member of The Robla School District Board of Trustees for over 20 years. He also currently hosts a daily news and commentary show called “The RUNDOWN.” You can follow him on X at @CraigDeLuz.

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