In a troubling trend, PrairieStar Health Center, a nonprofit community health facility in south-central Kansas, has filed lawsuits against patients for unpaid medical bills, with some amounts as low as $59. This has raised questions about the center’s mission to provide affordable health care in an area where many families struggle financially. In June 2023, Ashley Voss-Barnes received a court summons for a debt of $675, while her wife faced a $732 claim, prompting Voss-Barnes to challenge the lawsuit.
Voss-Barnes, a nurse familiar with the healthcare system, had previously arranged a payment plan with PrairieStar to manage their medical expenses. She stated in a court filing that the center never communicated that their payments were insufficient to cover their debts. “If I have something due, then I will try to pay it,” Voss-Barnes told ProPublica. “It came out of nowhere.” After attempts to retain legal assistance failed due to the low amounts involved, she represented herself in court, eventually settling with a collections agency to avoid wage garnishment.
The lawsuits filed by PrairieStar are part of a broader issue; the center has reportedly initiated over 1,000 lawsuits against patients since 2020, as revealed by a ProPublica analysis of state court records. Many of these patients are uninsured and qualify for discounted care, raising concerns about the center’s adherence to its foundational goals. Community health centers, created to serve as safety nets for low-income Americans, receive federal funding to provide care regardless of an individual’s ability to pay.
Despite their intended purpose, several health centers have resorted to legal action against patients, which experts argue contradicts their mission. ProPublica identified additional centers in Kansas, Virginia, and Michigan that have similarly pursued lawsuits against patients since 2020. This trend has alarmed health advocates who argue that such practices hinder access to necessary care.
In response to inquiries, PrairieStar’s CEO, Bryant Anderson, described the financial challenges faced by the center. He stated that the organization attempts to contact patients at least six times before taking legal action. Anderson emphasized that every patient is offered the opportunity to apply for sliding-scale discounts based on income, although he noted that about a third of patients decline to provide the necessary information.
Other health center leaders, including Renee Hively, CEO of CareArc, acknowledged the conflicting nature of pursuing patient debt while striving to provide care. Hively indicated that such decisions are not taken lightly, highlighting the financial instability that many community health centers face. She noted that while pursuing debts may seem at odds with their mission, it remains a necessary action for some centers.
Regulatory frameworks also play a role in these practices. Unlike nonprofit hospitals, which are required to check if patients qualify for financial assistance before pursuing legal action, community health centers must make “every reasonable effort” to collect payments before writing off debts. However, experts contend that this does not mandate aggressive collection practices, including lawsuits.
The Eastern Shore Rural Health center in Virginia exemplifies this troubling trend, having filed over 7,000 lawsuits for unpaid medical bills over the past decade. This has resulted in garnishments from the wages of individuals primarily employed in low-wage sectors, creating a cycle of debt and financial distress for many families.
Patients facing lawsuits often report increased financial strain and are likely to avoid seeking medical care in the future, according to Miriam Straus, a policy adviser for Community Catalyst, a health advocacy group. The implications of these legal actions extend beyond individual patients; they challenge the integrity of community health centers and their ability to fulfill their missions.
The situation has prompted calls for reform in how community health centers handle patient debts. Experts advocate for regulations that would prohibit aggressive collection practices, including lawsuits for patients qualifying for financial assistance. The National Consumer Law Center suggests limits on interest rates and bans on wage garnishment for all patients to alleviate the burden of medical debt.
In contrast, some health centers have chosen to adopt more compassionate policies. The Community Health Center of Southeast Kansas, for instance, has committed to never outsourcing debt collection to maintain patient dignity. Its leadership emphasizes the importance of delivering care without adding further stress to financially vulnerable populations.
As community health centers navigate the complexities of providing care while managing financial sustainability, the balance between supporting patients and pursuing debts remains a critical issue. The trend of legal action against patients raises essential questions about the role of these centers in the healthcare ecosystem and their commitment to serving those in need.
