October 13, 2025
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North Carolina cancels $6.5B in medical debt

North Carolina Gov. Josh Stein announced Monday that more than 2.5 million residents will have over $6.5 billion in hospital medical debt erased under a state initiative approved by CMS that trades enhanced Medicaid reimbursements for hospitals eliminating old debts and adopting charity-care and collection reforms. Roughly 100 qualifying hospitals are participating, average relief is about $2,600 per person, debts will be removed from credit reports, and nonprofit Undue Medical Debt will mail 255,000 notices this week.

Health Politics

📌 Key Facts

  • CMS approved the plan; hospitals must erase debt back to early 2014 for Medicaid enrollees and eliminate additional debt for non-enrollees based on income.
  • Total relief exceeds $6.5 billion for more than 2.5 million residents, averaging about $2,600 each, with debts pulled from credit reports.
  • About 100 acute-care, rural, and university-connected hospitals statewide opted in; Undue Medical Debt to send 255,000 notices this week.

📚 Contextual Background

  • Medicaid is a government health insurance program for people with low incomes or disabilities and is funded jointly by state and federal governments.
  • Medicaid spending is typically one of the largest components of U.S. state budgets.