In This Kansas Courtroom, the Hospital Dominates the Docket - WSJ
PRATT, Kan.—Last summer, a rural hospital on the Kansas plains began filing dozens of lawsuits against patients who hadn’t paid their medical bills. In July and August 2023, four of every five sheriff-delivered court summonses in Pratt County were from Pratt Regional Medical Center. In September, 95% of civil cases set to be heard in Magistrate Judge Ronald Sylvester’s Pratt courtroom were brought by the hospital. By December, it had sued some 400 people in a county of 9,000—more than it had in the past five years combined.
The debt-collection spree is an example of how some hospitals in recent years have become more aggressive in recouping bills from the estimated more than 15 million Americans who have medical debt. The issue can be particularly acute in rural areas like Pratt, where residents are more likely to be older and uninsured, and hospitals are under financial stress. More than 150 people in Pratt had wages ordered garnished in 2023, from employers that included Walmart, the hospital, the county clerk’s office and the school district. Most were ordered to pay 12% interest after judgment, an amount set in statute.
There was more than $49 billion in outstanding medical bills in collections last June, according to a Consumer Financial Protection Bureau estimate based on credit-report statistics. Other analyses peg the amount of medical debt closer to $200 billion. Major credit bureaus have in recent years begun removing medical debt from consumers’ credit reports.
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Kansas is one of 10 states that hasn’t expanded Medicaid, which advocates say would bolster hospitals’ financial margins. Four of five rural Kansas hospitals recently reported losing money on patient services, according to the Center for Healthcare Quality and Payment Reform, a national policy organization. Some states have responded to patient blowback over medical debt lawsuits by capping interest rates at 3% or blocking hospitals from placing liens on homes.
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Patients can appeal to the hospital to reduce their bills—nonprofit hospitals must offer their community some amount of charity care in exchange for their tax breaks—but patients often aren’t aware of that option or of how to apply.
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