By Alan Balch President Barack Obama has rightfully been emphasizing the importance of “middle-class economics.” The middle class is the heart of America. But even as the economy picks up as our nation recovers from financial crisis, many hardworking families continue to struggle.  

We at the National Patient Advocate Foundation believe any plan to rebuild our nation from “the middle out” must ensure that middle-class families are not subject to crippling medical debt — a problem that force millions of Americans to lose their health coverage, their homes, their good credit standing and their hard-won futures.  

Medical emergencies are not predictable, therefore individuals and families are usually not prepared when they occur. Yet, when they strike, they quickly become all-consuming and often financially devastating. Today, more than 1 in 5 Americans under age 65 are having trouble paying medical bills. More than 60 percent of all bankruptcy filings now involve medical debt. And for the first time, the average cost of health care for the typical American family exceeds $22,000 annually.  

Unexpected health care costs associated with significant conditions like cancer is putting a strain on middle-income Americans. Therefore, strengthening the middle class — and our nation as a whole — begins with ensuring access to care, while removing the looming shadow of financial hardship.  

For nearly two decades our sister organization, the Patient Advocate Foundation, has battled for patient access to much needed care. To date, our case managers have provided direct services and support to more than 750,000 Americans facing chronic, debilitating and life-threatening illnesses. These patients come to us for help with a variety of issues related to their ability to access and afford recommended care. Each patient we help conveys a unique story of hardship and carries a deeply personal burden. When pieced together, these myriad tales — ranging from crippling medical debt to inadequate transportation to coverage denials — paint a startling picture.  

Through our work in the trenches, we have a unique perspective on issues that touch the everyday lives of Americans.  

In 2014, approximately 60 percent of PAF’s patient cases involved financial distress. This number demonstrates an unsettling theme that when it comes to health care, more often than not, our overall well-being is directly related to the depths of our pockets. Clearly we must do more to ensure affordable care to all. Policy initiatives that establish consumer protections for Americans facing debt, or far worse declaring bankruptcy, as a result of the cost of their medical treatment are an important first step.  

America needs legislation that tangibly counteracts the disastrous effects of medical debt.  

Congress can act quickly to assist middle-class patients by passing common-sense legislation that has enjoyed bipartisan support in years past.  

Patients who are hit with an unexpected medical bill deserve an opportunity to settle their debt before it has a negative impact on their credit score. The Accuracy in Reporting Medical Debt Act has been introduced in three consecutive Congresses, and would allow patients a 120-day grace period to deal with debt collectors that contact them seeking payment on delinquent medical debt.  

Patients who fully pay or settle a medical debt should not have their credit score harmed because of an event they could not control. Introduced in 2013, the Medical Debt Responsibility Act would prohibit a consumer reporting agency from making any report containing information related to a fully paid or settled medical debt, so patients can focus on getting healthy rather than worrying about their ability to secure housing, transportation, or credit.  

Patients who are forced into bankruptcy because of medical debt deserve to move through the process as swiftly and painlessly as possible, so they can focus on their health. The Medical Bankruptcy Fairness Act of 2014 would have amended Title 11 of the United States Code to provide protection for medical debt homeowners, restore bankruptcy protections for individuals experiencing economic distress as caregivers to ill or disabled family members, and exempt from means-testing debtors whose financial problems were caused by serious medical problems.  

These bills have enjoyed bipartisan support in the past, and would provide tremendous benefit to patients struggling with medical debt.  

At some point, we are all patients. Therefore, lawmakers inherently understand the value of patient-centric reform. 2015 is a new year with a new opportunity to further improve our health care system. So let’s finally get back to basics and strengthen our health infrastructure for the people it is meant to serve: patients.  

Dr. Alan Balch is CEO of National Patient Advocate Foundation.

The 114th: CQ Roll Call’s Guide to the New Congress


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