The Atlanta Regional Collaborative for Health Improvement (ARCHI) recently partnered with the nonprofit RIP Medical Debt (RIP) to explore the effects of medical debt on the lives of people living in Atlanta. The findings were recently released in Understanding the Impacts of Medical Debt on Atlantans which explores their perceptions of medical debt and its causes, steps Atlantans have taken to resolve the debt, their interactions with providers and collections agencies, and what it would mean to have their debt abolished.
Medical debt is increasingly a source of stress and strain for many Atlantans, particularly in disadvantaged communities. In 2022, the Urban Institute estimated that 14.5 percent of people living in Fulton and DeKalb counties were carrying medical debt, amounting to more than 181 million being owed. Healthcare debt is the No. 1 reason people file for bankruptcy and it prevents people from accessing necessary healthcare in the future and leads to emotional and psychological harm.
ARCHI and RIP Medical Debt engaged PerryUndem to conduct focus groups with moderate- and low-income Atlanta residents who have and/or had medical debt. Groups were segmented by race and ethnicity to learn about different experiences with medical debt and understand intersections with structural racism. Interviews included participants with different health coverage situations like employer-sponsored health insurance, Medicaid and uninsured.
Key findings from the report about how medical debt impacts Atlanta residents include:

Medical debt causes mental health anguish. The debt weighs on people, and many say they experience anxiety and depression because of it.
Many times debt impacts people of color more often. In the focus groups, people of color said they believe their communities are more impacted by medical debt. Some say it is because structural racism makes it harder for them to obtain health coverage and good-paying jobs. Hospitals and insurance companies tend to treat them differently too, according to some participants, and can be aggressive in pursuing payment from their communities.
Debt puts health at risk. Many share how they delay or skip medical care because they fear incurring new debt or worry the hospital won’t treat them until they pay the bill.
Everyone wants relief. If their medical debt was paid, they say it would be one less worry in their life. They could gain some peace – which most lack currently – and it would help them obtain some level of financial stability.

To read the full report, visit the ARCHI Resource page.
“Ultimately, participants felt that big, systemic change is required to address the problem of medical debt,” said Meredith Swartz, Interim Executive Director, ARCHI. “Building a system that does not create the burden of debt would be a system in which all people are adequately insured and healthcare services are accessible in all parts of Georgia.”
Another key finding of the report was that those who had their debt abolished by RIP Medical Debt say it was extremely helpful. “They are grateful and say it made a difference,” said Allison Sesso, President and CEO, RIP Medical Debt. “It relieved the constant pressure of their debts. Some also sought healthcare services once their debt was paid – care they had been putting off – because they felt less vulnerable. And at least two Atlanta residents said having their medical debt abolished was a catalyst to paying down other debts – they could see the light at the end of the tunnel.”
ARCHI has partnered with RIP Medical Debt to continue to relieve medical debt for Atlantans. RIP uses donated funds to acquire medical debts belonging to those in financial need and abolishes the debt, avoiding the collections process. The organizations have engaged Mercy Care to relieve medical debt for their patients.

“For the people receiving debt relief notices from RIP Medical Debt and ARCHI, this abolishment is a lifeline,” said Kathryn Lawler, CEO, Saint Joseph’s Health System/Mercy Care. “However, we know for lasting impact to occur, change must happen within the healthcare financing system and the policies that govern debt collection buyers and sellers to create a more transparent, equitable and effective process to increase the health and well-being of all.”

Since its inception, ARCHI and its 110-plus partners have developed innovative solutions aimed at solving some of healthcare’s greatest challenges around care coordination and issues such as housing, healthcare inequity and Covid-19 best practices. Working with RIP Medical Debt aligns with the organization’s goal of collaborating across public-private sectors to create lasting change. ARCHI and its partners seek to invert the burden of navigating complex and siloed services and address social determinants of health such as medical debt. Debt collection tactics harm not only the finances but the overall health of people already under significant financial strain and hamper the social and financial well-being of entire communities.