Community health centers, designed to provide affordable medical care, are facing scrutiny for their practices of suing patients over unpaid medical bills. In a troubling case, PrairieStar Health Center, a nonprofit center in south-central Kansas, filed lawsuits against patients, including Ashley Voss-Barnes, for amounts as small as $59. This has raised questions about the centers’ commitment to their mission of delivering accessible health care to vulnerable populations.
In June, Voss-Barnes received a court summons stating that PrairieStar was suing her for $675 and her wife for $732 in unpaid bills. Despite knowing that PrairieStar received federal funding to help families afford preventive care, Voss-Barnes was caught off guard by the lawsuit. She had previously arranged a payment plan with the clinic but was unaware that her payments were insufficient to prevent her account from going into collections. “If I have something due, then I will try to pay it,” she told ProPublica. “It came out of nowhere.”
Faced with a lawsuit she did not anticipate, Voss-Barnes sought legal counsel but found it difficult to secure representation due to the small amount of debt involved. Ultimately, she represented herself in court, filing an objection to the lawsuit while seeking to continue her existing payment plan. After negotiations, Voss-Barnes and her wife established new payment arrangements with a collections agency, but they ended up incurring additional costs in interest, court fees, and legal expenses.
According to an analysis by ProPublica, PrairieStar has filed at least 1,000 lawsuits against patients for unpaid medical bills since 2020. Many of those targeted were uninsured and eligible for discounted care, highlighting a significant gap between the center’s stated mission and its actions. Community health centers like PrairieStar, known as federally qualified health centers, were established to serve as safety nets for low-income individuals who might otherwise forgo medical attention due to financial constraints.
The findings reveal that PrairieStar is not alone in this practice. Similar lawsuits have been filed by other health centers in Kansas, rural Virginia, and Kalamazoo, Michigan since at least 2020. Despite their mission to provide accessible health care, these centers are pursuing patient debts that contradict their foundational goals.
In response to inquiries about these practices, PrairieStar CEO Bryant Anderson emphasized the financial challenges facing the center, describing it as a “perfect storm” of rising costs and unstable funding. He stated that PrairieStar makes multiple attempts to communicate with patients before resorting to collections. “Having someone imply that we don’t fulfill our mission is certainly rubbing salt in the wounds,” he stated in an email.
Other community health center leaders echoed Anderson’s sentiments, explaining that they see legal action as a last resort after exhausting other methods of debt recovery, including sending statements and offering payment plans. They pointed to ongoing financial instability as a reason for pursuing patient debts.
Contrasting PrairieStar’s approach, a spokesperson for a health center in Monterey County, California, noted that they have not sued patients since 2019, stating that most unpaid bills they send to collections involve amounts too small to justify legal proceedings. This highlights a significant disparity in how various health centers handle patient debt.
While much of the public discourse surrounding medical debt has focused on hospitals, it is essential to consider the implications for community health centers as well. These centers are required by federal law to make “every reasonable effort” to collect from patients before writing off debts. However, experts argue that this does not necessitate pursuing collections through lawsuits.
Ray Jorgensen, a healthcare billing consultant, stated, “There’s no law that says you have to garnish wages or that you have to go after someone through collections.” This perspective suggests that PrairieStar’s aggressive approach to debt recovery is not the norm among community health centers.
In Virginia, for instance, Eastern Shore Rural Health has filed over 7,000 lawsuits for unpaid medical bills in the last decade, with amounts as low as $59 ballooning due to interest and court costs. This has particularly affected low-wage workers in industries like poultry processing and retail, illustrating the real-life consequences of such legal actions on already vulnerable populations.
The community health center landscape is complex, with leaders like Krista Postai of the Community Health Center of Southeast Kansas advocating for a different approach. Her facility avoids sending patients to collections, focusing instead on maintaining patient dignity and finding creative solutions to expand access to care. “Most people try to pay,” Postai said, emphasizing the importance of working with patients rather than resorting to aggressive collections.
As community health centers continue to grapple with financial challenges, the debate around their debt collection practices raises important questions about their roles in providing equitable health care. The potential for patients to avoid seeking necessary medical care due to fear of legal repercussions underscores the need for a reevaluation of how these institutions manage patient debt.
Overall, the situation reveals significant discrepancies in the operational practices of community health centers and raises concerns about their commitment to serving the most vulnerable populations. The choices made by these centers could have lasting implications not only for their financial health but also for the well-being of the communities they aim to serve.
