>> as >> you heard health care, affordability is a concern for many and with local health care providers bracing for nearly 400,000 Illinoisans to lose Medicaid access over the next year.

Existing challenges could get more complicated.

One of those is medical debt which affects nearly one quarter of U.S.

adults earlier this month, Illinois health officials announced the state's medical debt relief program surpassed 1 billion dollars in relief while costing the state only 10 million dollars.

Joining us to explain that our staff wilding, the CEO of Community Health, Volunteer based Health Center in Chicago and Courtney Work.

The story, the vice president of government initiatives that medical debt, a nonprofit that contracts with the state of Illinois.

Thanks to you both for joining us.

Thank Courtney, starting with you, please.

This.

The state spent 10 million dollars to relieve 1.4 billion dollars in debt.

Asked that for us.

Explain that works.

Clean Houston.

Yeah, not a cult that we believe that medical debt is the debt of necessity.

Not Know things do get sick or injured and no one face financial hardship because they need medical care.

>> We aren't able to have such a great are alive because we purchase qualifying by the close from hospitals, providers and collection agencies directly often for a penny or less on the dollar and then we abolish it entirely.

There is nothing that patients need to do, which is what I think is the best part of our program.

There's no application, no cost and the tax consequences.

They simply received letter in the mail, letting them know that their medical that has been erased.

And Illinois has just been a tremendous partner in this work.

And like you side with that 10 million dollar investment, we have able to abolish more than 1.4 million 1.4 billion dollars in medical for over 694,000.

Residents across the state.

And with that purchase, you know, for pennies on the dollar, you know, of hospitals.

If they've been working to collect that debt, why would they sell it for so little?

>> At this point in the collections process, the hospitals have been unable to clocked at the medical that that we abolish is for families that are 400% of the federal poverty level or below.

than $100,000 a year for a family of 3.

So it's not that people don't want to pay at the camp.

As we heard in the last segment, the affordability crisis is hitting everybody right now and people just don't have the funds to pay very high medical bills.

>> Okay.

So that hospitals would rather get a little something rather than nothing at all, which is what they have been getting.

Staff medical that compound other challenges with accessing medical care.

Yeah, absolutely.

You know, when someone has to take on medical debt for the care that they received yesterday, that actually impacts them wanting to seek care tomorrow that they may need.

>> The burden off that that ends up becoming a significant barrier and then accessing care resulting in patients delaying doctor's appointments, preventive cancer screenings, patients who may have chronic diseases such as diabetes or hypertension, will avoid critical care that they need spread out their medications all in an effort to avoid taking on additional Det, which ultimately means that cancers are found later.

Disease management is a challenge.

Andy, do you do should emergency department utilization tends to rise staff of 2025 investigation from Illinois Answers Project found the majority of medical debt relief in Cook County went to people should have qualified for charity care in the first place.

>> What are the barriers for accessing charity care?

Why were these folks indebted versus receiving that charity Care?

Yeah.

Charity Care is an incredible program and it comes with a number of hoops that that families have to jump through.

>> In order to fill out that application qualify, including the order in which you seek out charity care, which often is after you've already received a bill and received that But Dish you know, if you speak another language, Spanish or polish like the patients at community Health, there's a language hoops a lot that folks have to jump through in order to be able to submit those applications and get approved and the administrative burden ends up becoming a critical barrier for being able to qualify for charity care.

Courtney, a criticism of medical debt relief has been that it comes too late to make a major impact.

That by the time the has been sold or forgiven for those pennies on the dollar, like we discussed earlier >> collectors, the hospital they've already given up on trying to collect that debt.

How do you assess the impact of debt relief programs?

>> Yeah, I mean, I think one of the most important ways that we can help both to get there earlier and earlier.

And that's exactly why we work directly with hospitals and health care providers.

Our model has significantly changed over the last several years.

And we are find that earlier and earlier in the election cycle.

And that is exactly the stuff just side the ways to make that impact for patients.

Even if the hospital is not collecting on it, the patients still knows that they it in the show up in their portal.

When they log and share, they may not seek that care that they need because they're afraid of additional bill are being asked to pay bill that they know that they so that is why medical debt relief is so important because it gives that he said the freedom and the ability to return to care without think our goal continues to be to abolish as a Polish as as we can as early in the cycle as possible.

>> And Courtney, explain if you would, the partnership that your organization has with Illinois.

>> Yeah, we have utilized the 10 million dollar investment that they made it make those purchases from hospitals across the state.

We worked with hospitals in Chicago up rock and roll hospitals in Illinois and we work with small clinics and that their investment has really allowed us to make that partnership happened.

abolished like aside more than 1.4 billion dollars and got a call that we've also receive friends from Cook County as well.

So all together in the state of Illinois between those 2 programs, we have a almost 2 and a half billion dollars in medical debt and both the state and Cook County have indicated that they would like to continue these programs in the future.

So we are really just beginning our work in the state.

>> Stephen few seconds left, but how can community health keep up with the rollbacks that seeing going to be seeing in Medicaid eligibility?

Yes, absolutely.

We've already begun to see 100 nearly 100,000 people opt out of marketplace plans and choose not to be insured because their subsidies expired on January.

First, Medicaid work requirements will go into effect where anywhere 150 to 300,000 individuals potentially going to lose their coverage to places like community health that serves exclusively and on insured population.

This is our time to really step up.

Do all that we can because we want to make sure that we are able to not only be key pillar in the safety net but be able to support others in the safety