Activists rally against Johns Hopkins hospital in Baltimore, which has filed more than 2,400 lawsuits against patients and employees

Campaigners are calling on one of Maryland’s largest hospitals to drop more than 2,400 lawsuits against patients for unpaid medical bills.

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A report published in May revealed that Johns Hopkins hospital (JHH), one of the biggest hospitals in the state, filed more than 2,400 lawsuits against patients for not paying their medical bills, the median cost of which was $1,438.

Hundreds of people protested outside the hospital in Baltimore on Saturday. The rally was sponsored by the community advocacy group Coalition for a Humane Hopkins and two unions, including National Nurses United, which pushed for nurse unionization at the protest.

“[JHH] can completely abandon this predatory, debt-seeking behavior,” said Bonnie Costillo, the executive director of National Nurses United. “They can do that tomorrow. We’re not just asking, we’re demanding.”

Most of the patients live in the hospital’s surrounding areas, in primarily poor and African American communities, according to the report. The hospital also filed over $76,000 worth of lawsuits since 2009 against their own employees, who are also patients at the hospital.

Like nearly 3,000 other hospitals in the United States, JHH gets tax breaks for its status as a not-for-profit hospital. Although not-for-profit hospitals suing its patients for medical debt is controversial, it is not new. No one tracks how often not-for-profit hospitals sue their patients.

The average American family of four spends about $28,000 on healthcare a year, even with insurance. Medical debt is considered a “low priority debt” by the National Consumer Law Center because it comes with little to no interest, yet a 2016 study found that one in six Americans have medical debt on their credit reports, worth a collective $81bn.

Some hospitals have suspended their debt collection lawsuits after coming under scrutiny. A ProPublica report last month found that a not-for-profit hospital in Tennessee filed 8,300 lawsuits against its patients over a four-year period. NPR found that a hospital in Virginia sued so many of its patients, the local court reserved a morning every month to go through its cases. The hospitals said they would suspend their lawsuits just days after they were made public.

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The number of medical lawsuits JHH filed dropped significantly after the Baltimore Sun published a special series that investigated the lawsuits in 2008. The newspaper found the hospital and a partner hospital filed 14,000 lawsuits in a five-year period. Over time, the hospital started to file lawsuits against its patients again, going from a low of 20 lawsuits in 2009 to a high of 535 in 2016.

In a statement to the Guardian sent in May, a spokesperson for Johns Hopkins Medicine said: “It is our practice to inform our patients about our programs for free and discounted services. For patients who choose not to pursue those options or who have a demonstrated ability to pay, we will make every effort to reach out to them and to accommodate their schedule and needs. In those rare occasions when a patient who has the ability to pay chooses not to, we follow our state required policies to pursue reimbursement from these patients.”

Johns Hopkins Medicine did not respond to further requests for comment in response to the protest.

Marisela Gomez, a public health consultant and member of Coalition for a Humane Hopkins, said JHH and its surrounding community has historically had a strained relationship. The medical debt lawsuits has only furthered tensions between the hospital and patients.

Gomez said: “The hospital that employs thousands of doctors, physicians and healthcare providers that took an oath to do no harm, is systematically exploiting people and causing them harm. You enter [the hospital] to get care, to feel well, to decrease your stress. Any benefit that has come from that encounter has been completely diminished.”