In a troubling development, community health centers, intended to provide affordable medical care, are facing criticism for pursuing legal action against patients for unpaid medical bills. This includes PrairieStar Health Center in south-central Kansas, which has filed over 1,000 lawsuits since 2020 for amounts as small as $59. These actions contradict the mission of federally qualified health centers, which are designed to serve low-income populations.
In June 2023, Ashley Voss-Barnes received a court summons indicating that PrairieStar was suing her for $675 in unpaid medical bills, while her wife faced a claim for $732. Voss-Barnes, a nurse familiar with navigating the healthcare system, was shocked by the lawsuit. She and her wife had previously established a payment plan with the clinic, believing it would prevent such actions. Voss-Barnes claimed in court documents that PrairieStar never communicated that their payments were insufficient to cover their debts. “If I have something due, then I will try to pay it,” she stated. “It came out of nowhere.”
After initially seeking legal representation, Voss-Barnes opted to represent herself in court. She successfully negotiated a new payment plan with a collections agency to avoid wage garnishment, but this decision resulted in additional costs, including hundreds in interest and legal fees. The couple remains concerned about the possibility of further lawsuits from PrairieStar.
The financial practices of PrairieStar and similar health centers have come under scrutiny. According to an analysis by ProPublica, many patients sued by PrairieStar were uninsured and earned low incomes, making them eligible for discounted care. Community health centers were established during the Civil Rights Movement to address the needs of low-income Americans who faced barriers to accessing healthcare. Funded by federal grants, these centers are meant to offer services regardless of patients’ ability to pay.
Yet, PrairieStar’s actions raise questions about its commitment to this mission. Bryant Anderson, CEO of PrairieStar, described the financial challenges faced by the clinic, emphasizing that their decision to pursue legal action is a last resort after multiple attempts to contact patients. He stated, “With all the challenges PrairieStar faces to maintain access to care for the uninsured and the underinsured, having someone imply that we don’t fulfill our mission is certainly rubbing salt in the wounds.”
Other community health centers have adopted similar practices. For instance, Eastern Shore Rural Health in Virginia has filed more than 7,000 lawsuits for unpaid medical bills over the past decade. A couple was even sued for an initial amount of $59, which escalated dramatically due to added fees. The center claims that it attempts to exhaust all other options before resorting to collections, including sending payment reminders and offering payment plans.
Critics argue that such aggressive debt collection practices undermine the original purpose of community health centers. Medical debt disproportionately impacts marginalized communities, including Black and Hispanic populations, who rely on these facilities for affordable care. Miriam Straus, a policy adviser for Community Catalyst, expressed concern, stating, “Patients who have been sued because of medical debt are likely to avoid care in the future.”
In response to these ongoing issues, some community health centers have chosen not to pursue legal action against patients. The Community Health Center of Southeast Kansas, led by Krista Postai, has implemented policies to prevent sending patients to collections, emphasizing patient dignity and access to care. Postai’s center serves a high percentage of low-income patients and prioritizes maintaining affordable care options.
The growing visibility of medical debt lawsuits has prompted advocates to call for reform. The National Consumer Law Center recommends capping interest rates on medical debt and prohibiting lawsuits against patients who qualify for financial assistance. These changes aim to protect vulnerable populations from the financial devastation caused by aggressive debt collection practices.
The legal and financial practices of community health centers will likely continue to be scrutinized as more patients like Voss-Barnes share their experiences. The intersection of healthcare access, affordability, and legal accountability remains a critical issue, underscoring the need for systemic reforms to ensure that community health centers fulfill their mission to provide care for all, regardless of financial circumstances.
