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At this point in the ongoing COVID-19 pandemic, more than 5,750,000 people in the United States have tested positive and there have been nearly 180,000 deaths. The pandemic has caused broad shutdowns of economic activity, resulting in more than 23 million Americans losing their jobs. While the unemployment insurance supplement legislated by Congress expired at the end of July, and millions are moving from being temporarily furloughed to permanently unemployed, some hospital systems are positioned to profit handsomely. One such entity is Community Health Systems, Inc. (CHS), a for-profit hospital chain operating or leasing 94 hospitals in 16 states. CHS lost $287 million during the first half of 2019 but has since rebounded. They have reported earnings of $70 million during the second quarter of 2020 for a total of $87 million during the first half of 2020. The reason for this recovery in earnings, according to the company, was the receipt of COVID-19 federal relief funds. As of late July, they had received $448 million, courtesy of U.S. taxpayers.
This should be great news for current and former CHS patients who are struggling to pay bills, including their medical bills. After all, the CHS corporate website clearly states that CHS affiliated hospitals are “…dedicated to providing quality healthcare for local residents,” and that in addition to providing essential services, they “…stimulate the economic health of their communities, pay taxes, provide charity care and are often among the largest employers in town.” Yet, while the official position is that “…every CHS-affiliated hospital works to improve the wellbeing of local residents through health fairs, screenings and educational programs,” their billing practices paint a very different narrative.
In the fall of 2019, CHS hospitals came under scrutiny for their aggressive collection practices. The New York Times reported that one CHS hospital filed lawsuits by the thousands against its past patients. Patients reported being surprised to learn that CHS puts liens on their homes and garnished their wages. In many cases, patients were not notified of their medical debts nor given a chance to discuss a payment plan until after they were sued or their application to refinance their mortgage was denied.
Such practices can disproportionately harm particular groups. For example, research has revealed that legal debt collection actions and wage garnishments are more frequent within Black communities. With Black households earning markedly less than white households, they are less financially secure to begin with and aggressive collection actions put them at even greater risk.
During the pandemic, millions of workers have lost their jobs and are struggling to maintain their health insurance and pay medical bills in addition to managing the financial stress of maintaining housing and access to other basic needs. What has been the CHS response during the pandemic? Business as usual. The system continues to pursue legal action against patients, even in COVID-19 hotspots such as Florida, Texas and Arizona. In these states, it has been reported that dozens of CHS-affiliated hospitals continue to haul people to court. One patient pleaded with the judge that his weekly take-home pay of $525 was insufficient to pay the nearly $35,000 bill plus court fees, attorneys’ fees and interest being pursued by CHS. CHS’s recent actions illustrate that hospitals will not necessarily be as generous with their patients as the federal government has been with them.
Institutions receiving federal relief funds should be accountable to U.S. taxpayers and the communities they serve. Their actions should not further destabilize the lives of low- and moderate-income people. At least two U.S. Senators agree. Senators Van Hollen and Murphy have introduced legislation – The COVID-19 Medical Debt Collection Relief Act of 2020 – to protect patients who are unable to pay their medical bills during the pandemic. If passed into law, the bill would prevent health care providers from seizing patients’ bank accounts and wages as a mean to collect outstanding medical bills.
Federal COVID-19 relief funds are critical to ensuring that the U.S. has a stable health delivery system, and must be tied to protecting both patients and health systems alike. In addition, as the issue of longstanding inequity in access to resources and health care gains renewed attention, it is important to directly respond to the disproportionate effects on people of color and protect them from further harm, as this legislation would do. We call on Congress to immediately enact The COVID-19 Medical Debt Collection Relief Act of 2020 into law. We also encourage CHS and other providers receiving federal relief funds to immediately cease legal actions against patients with outstanding medical bills. To do any less, at this time, is simply outrageous and callous.