At a time when healthcare policy dominates national debate, a county in Kansas is jailing individuals with medical debt.

Judge David Casement is a magistrate judge in Coffeyville, Kansas, where the poverty rate is twice the national average. He presides over cases in which individuals with medical debt are brought to court to face the medical companies they owe. During the hearings, the debtors must make a case for their own poverty during what is known as a “debtors exam.”

The practice was detailed extensively in a ProPublica report from October.

One of the debt collectors at the center of the debtors exams, an attorney named Michael Hassenplug, has essentially built a law practice around collecting medical debt.

Mr Hassenplug influenced the creation of a law under which the court can compel people with outstanding medical bills to appear in court every three months and make a defense of their poverty.

During the hearings, debt collectors can assess the financial situations of the debtors and afterward attempt to negotiate payment plans. If a debtor misses two hearings, Mr Casement issues an arrest warrant for contempt of court and sets bail at $500.

Mr Hassenplug gets paid a portion of the debtor’s bail money. Generally when a defendant appears in court, their bail money is refunded. In Coffeyville, however, bail money is used to pay attorneys fees and medical companies who are owed debt.

Tre Biggs was one of the individuals who found themselves on the receiving end of the law.

Biggs’ family suffered from numerous medical issues. His five-year-old son had leukemia and his wife, Heather, suffered from seizures related to Lyme disease.

“We had so many, multiple health issues in our family at the same time, it put us in a bracket that made insurance unattainable," Ms Biggs said in an interview with CBS News. "It would have made no sense. We would have had to have not eaten, not had a home."

When Mr Biggs failed to appear in court - at the time he was working two jobs, but still fell behind paying the family’s debt - he was sentenced to prison.

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“I was scared to death. I’m a country kid, I had to strip down, get hosed and put on a jumpsuit,” he said. “You wouldn’t think you’d go to jail over medical bills.”

Mr Biggs said his family had access to “$50 to $100” at the time of his arrest. His bail was set at $500.

Nusrat Choudhury, the deputy director of the ACLU, said the county’s practice raises “serious constitutional concerns.”

“What’s happening here is a jailhouse shake-down for cash that is the criminalization of private debt,” he said.

Since the use of debtors exams in Coffeyville gained notoriety, Mr. Hassenplug’s Yelp page has been attacked by individuals who take exception to his methods. Outraged users have tanked his business rating to 1 star and have peppered his page with photos of faeces and other unpleasant images.