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What Happens After a Debt Collection Machine Grinds to a Halt

Analysis  |  By ProPublica  
   October 03, 2020

One year ago, Methodist Le Bonheur hospital system erased nearly $12 million of medical debt after an investigation from MLK50 and ProPublica. We checked in with two women who have new jobs and a new optimism about their future.

This article was published on Friday, October 2, 2020 in ProPublica.

By Wendi C. Thomas, MLK50: Justice Through Journalism

A year after Methodist Le Bonheur Healthcare erased the $33,000 Carrie Barrett owed for unpaid hospital bills, the former Kroger grocery store clerk is figuring out how to open the food truck she’s always dreamed of.

The nonprofit hospital system also erased more than $23,000 in debts owed by one of its own housekeepers who it sued for unpaid bills. And now she’s dreaming of home ownership.

It’s been one year since MLK50: Justice Through Journalism and ProPublica reported that Methodist was quietly erasing the debt owed by thousands of patients it’d sued over the past 19 years for unpaid hospital bills.

The debt cancellation, which wiped out nearly $12 million owed by more than 5,300 defendants, followed an investigation by the news organizations into the faith-based hospital’s relentless efforts to collect on bills from low-income residents and even its own employees.

The hospital effectively ended the legal proceedings by filing thousands of notices with Shelby County General Sessions Court stating that the defendants’ balances were now zero. The case-satisfied notices flooded the court clerk’s office weeks after Methodist announced sweeping policy changes, including a far more generous charity care policy. More than half of the residents in the Memphis, Tennessee, metro area would qualify based on their household income.

While Methodist’s decision to eradicate so much debt lifted a financial and psychological burden for many, it only addressed a piece of one of the myriad systems — such as low-wage jobs, lack of transportation and substandard housing — that make it hard for families to make ends meet.

I’ve stayed in touch with some of the defendants featured in last year’s investigation, including Barrett, then a Kroger deli clerk who made $9.05 an hour, and a Methodist housekeeper who earned $12.15 an hour. I granted the housekeeper anonymity at the time because she worried that the hospital would fire her for talking to a journalist.

Today, Barrett said she’s caught up on her bills, thanks in part to the generosity of a stranger who offered help after reading the initial stories.

Marilyn Boyd, who no longer works at the hospital and has now agreed to allow her name and photo to be used, said her finances are slightly better. She said she owes Methodist several thousand dollars for a 2014 surgery, but she hasn’t been sued.

Still, neither has enough left after paying bills to establish an emergency fund. And in the last few months, unexpected expenses — for both of them, car repairs — forced them to borrow money.

A Debt Collection Machine Grinds to a Halt

Methodist filed more collection lawsuits in Shelby County General Sessions Court between 2014 and 2018 than all but one creditor.

Because it’s a nonprofit, Methodist is required to offer some sort of financial assistance to low-income patients, although the IRS does not dictate how generous that assistance is.

For years, so many defendants sued by Methodist came to court that their cases consumed almost all of a courtroom’s docket on Wednesday mornings, when a judge would hear nothing but Methodist’s cases.

On one side would be a pair of Methodist attorneys and a contingent of Methodist employees. On the other side was the defendant — usually a black woman, almost never represented by an attorney. In front was a General Sessions Court judge, who was often unsympathetic to the defendants’ request to pay less per month than Methodist wanted.

A comparison of the number of cases filed in the months and years before and after MLK50-ProPublica’s investigation illustrates how Methodist’s presence at the court went from massive to virtually nonexistent.

In 2018, the hospital filed just under 1,500 lawsuits, according to Shelby County General Sessions Court records.

Between Jan. 1 and June 30, 2019, the hospital filed close to 700 suits.

On June 27, MLK50 and ProPublica published the first story in the “Profiting from the Poor” investigation. Three days later, the hospital’s president and CEO, Dr. Michael Ugwueke, announced the hospital would review its policies.

By July 3, 2019, the hospital had begun dropping lawsuits it’d filed against defendants and the finely tuned debt collection machine ground to a halt.

Between July and December 2019, Methodist filed two lawsuits. In 2020, it’s only filed one suit. (Because of the pandemic, Shelby County General Sessions Court closed from March 13 to June 15.)

It’s great news “that the hospital has made changes to its policy, that it’s not further destabilizing people who got sick or injured and needed care,” said Mark Rukavina, business development manager at Community Catalyst’s Center for Consumer Engagement in Health Innovation.

Last year, Methodist estimated that raising the pay of its lowest-paid workers to at least $13.50 an hour would cost $14 million. It’s unclear how the other changes affected Methodist’s bottom line. The hospital declined an interview request for this story, as it has since MLK50 asked for an interview in June 2019.

“I’m Still Not Going to Give Up”

In 2007, Barrett spent two nights in the hospital after she complained of shortness of breath and tightness in her chest. Her initial hospital bill was just over $12,000.

The hospital sued her in 2010 and over the years, with attorney’s fees and added interest, her debt ballooned to more than $33,000. Fifteen times, Methodist garnished money from her paycheck.

When I met Barrett, she was in court, facing off with Shelby County General Sessions Court Judge Betty Thomas Moore, who’d ordered her to pay $100 a month toward the debt. If she’d paid as ordered and Methodist didn’t add any additional interest, she would have been 90 years old by the time she was debt-free.

“The only thing that kept me levelheaded was praying and asking God to help me,” she said last year.

When the debt was erased, she rejoiced — literally. At her church last year, she gave her fellow parishioners an update.

“I have a zero balance,” she said. “I just want to thank God for blessings that he has brought to me. … I thank him for the victory!”

Today, Barrett, 64, makes ends meet with her Social Security payment and the money she receives for being a foster parent. That, plus the money she makes catering — she’s already taking orders for Thanksgiving — covers her bills.

She’d anticipated that any foster child she had would be in school, but then the coronavirus pandemic struck. Shelby County Schools have been closed for in-person learning since March; school resumed in August, virtual only.

Earlier this month, she was frustrated: Her foster child was having difficulty logging on for virtual school.

“I’m not that good on the computer,” she admitted. “My mind ain’t equipped for all that.”

She doesn’t plan to return to Kroger, although it has offered her a job. She has her mind set on a career: Running a food truck.

“The food truck, I was trying to get stuff going with that, and I’m still not going to give up, because that’s my dream,” Barrett said.

Not long after the investigation was published, a woman in California reached out to Barrett to say she was touched by her story and horrified that the hospital had sued her. She sent Barrett money then and did so again just weeks ago.

The timing was perfect: Barrett had just taken out a payday loan to get her brakes fixed. She was able to use the woman’s gift to pay off the loan and catch up on some bills.

“She said she didn’t forget me and she was thinking of me during this coronavirus situation,” Barrett said.

Free to Hope for a Brighter Future

Perhaps what most shocked readers was that Methodist sued its own employees, including ones it paid very little.

A MLK50-ProPublica analysis of Shelby County General Sessions Court records, online docket reports and case files showed that between 2014 and 2018, Methodist won a judgment against and tried to garnish the paychecks of more than 160 Methodist employees, and actually garnished employees’ pay more than 70 times.

Between 2012 and 2014, Boyd visited Methodist five times for chronic stomach ailments. Insurance through her hotel housekeeping job, where she made $10.66 an hour, left her with $17,500 in hospital bills.

Methodist sued Boyd in 2017, before she started working at the hospital. In June 2019, she owed the hospital more than $23,000. Of that, $5,800 were attorney’s fees.

At a hearing last year in General Sessions Court, Boyd was wearing her hospital uniform, standing in front of a judge and attempting to negotiate a reasonable payment. Methodist’s attorneys wanted $200 a month, which she knew she couldn’t do, so she agreed to $75 every two weeks.

Other Methodist workers interviewed were furious that their employer had sued them, but Boyd was more resigned than angry. “You know how much you pay me. And the money you’re paying, I can’t live on,” Boyd said last year. Being an employee and defendant is “really kind of sad.”

Although Boyd was only making $12.25 an hour, she needed her job and was hesitant to use her name in the story or be identifiable in photographs, for fear the hospital would fire her.

My editors and I decided to grant Boyd anonymity, which eased her fears but also meant that she didn’t receive the same generous gifts from strangers who reached out directly to Barrett through her church.

But Boyd, 52, did benefit from another piece of the hospital’s broad reform measures: Methodist raised the pay of its lowest-paid employees to $13.50 an hour in September 2019 and has said it will raise the pay to a minimum of $15 an hour in January 2021.

When the coronavirus pandemic reached Memphis, Boyd was still cleaning hospital rooms, including those of COVID-19 patients. She worried that she’d catch the virus at work and infect her daughter, who had a high-risk pregnancy, or her grandchildren.

Her fears of catching the virus and the stress of the toll the virus wrought started disturbing her sleep.

“When you see people dying all day, people don’t think about it, but it messes with your mind,” Boyd said.

She started seeing a counselor.

“You’d have to have a cold heart” to remain unaffected by the deaths, she said. “But my heart is too soft. I don’t even know these people and I’m crying.”

In August, she left the hospital for a warehouse job that pays $15 an hour. “I can make a little more money and it’s less stressful,” Boyd said. She’s on her feet for the entire 12-hour shifts, so she’s saving up for better shoes.

After Methodist erased the debt, the collection item fell off her credit report. “It was a big chunk that came off my credit,” Boyd said. “My credit score is a little better now.”

“In a couple years from now, if I’m doing better, I want to get a house,” she said. “And if my credit is going up, I’ll be able to do those things one day.”

ProPublica is an independent, non-profit newsroom that produces investigative journalism in the public interest.


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