By Sam Prickett

Over the holidays, roughly 6,500 Alabama households received a notice in the mail that their medical debts had been purchased and forgiven by the Episcopal Diocese of Alabama.

Those letters were the culmination of a fundraising campaign undertaken by Saint Luke’s Episcopal Church in Mountain Brook, which commemorated its 70th anniversary by eliminating $8.1 million in medical debts throughout the Birmingham metro area and its surrounding counties.

More than 137 million Americans struggled with medical debt in 2019, according to a CNBC report. Those costs, usually unexpected, are reportedly the top reason people take money out of their retirement accounts or file for bankruptcy.

Many hospitals across the country sell their past-due bills to debt collection agencies for pennies on the dollar. Those agencies often take a much more aggressive approach to pursuing payment.

But collection agencies aren’t the only entities that can purchase medical debt. For its fundraiser, Saint Luke’s partnered with RIP Medical Debt, a nonprofit organization founded by two former debt collection executives that works with donors to purchase and forgive medical debt “from the neediest cases up,” according to its website.

The Rev. Cameron Nations, an associate rector at Saint Luke’s and organizer of fundraiser, said he found out about the organization through Emmanuel Memorial Episcopal Church in Champaign, Illinois, which last year partnered with RIP Medical Debt to forgive $4 million in medical debts.

The story hit home, Nations said, because he knew that church well; he attended it while he was in college. The story also stuck with him because $4 million, frankly, seemed like a lot of money.

“I was like, ‘How in the world did they do this?’” he laughed. “I was just astounded by that, because, I mean, they’re a healthy church, but it’s a very small parish — and I had seen their budget sheet. Unless they had some megadonor I didn’t know about, what was going on?”

He reached out to that church’s rector, who told him about RIP Medical Debt, and Nations realized it would be possible for his church to do something similar in Alabama.

“We had been talking about wanting to do something special to celebrate Saint Luke’s 70th birthday, which was this past year,” he said. That the church’s namesake, Luke the Evangelist, is historically believed to have been a physician only made the fundraiser seem more appropriate.

“Saint Luke in the Christian tradition didn’t just write one of the four gospels,” Nations said. “There’s been this long association in the Christian faith of Saint Luke with doctors, nurses, any kind of health care and healing in general. So we thought, ‘What better way to celebrate our 70th birthday than doing this fundraiser?’”

The Episcopal Diocese of Alabama quickly got on board, donating just more than $10,000 to kick off fundraising efforts. The church then raised $68,000 more, mostly from parishioners, though others in the community pitched in as well, Nations said. Because hospitals sell off unpaid bills at discounted rates, the church and RIP Medical Debt were able to buy $8.1 million in debt for just $78,000.

Recipients of the debt forgiveness were selected by RIP Medical Debt based on a series of criteria, which prioritized households rendered insolvent by medical debt, as well as households existing near or below the poverty line. The church also could purchase only debt still owned by hospitals; debts already sold to collection agencies were, unfortunately, off-limits, Nations said.

The fundraiser initially was focused on the Birmingham metro area; but when Saint Luke’s raised more money than it expected, it turned its focus to surrounding counties.

“Originally, we didn’t know what the response would be from folks, and we were hesitant at first to set a goal because we didn’t know what would make sense,” Nations said. “We didn’t want to set a goal that was unrealistic … . As we raised more money, we reached back out to RIP and said, ‘What are some other counties that are nearby?’ In the end, we were able to target 14 counties across central Alabama, from Jefferson all the way up to Morgan, over to Talladega and back down.”

In some counties, particularly Bibb and Talladega, “the need was just so great” that Saint Luke’s could not afford to address it. But Nations said that a major priority of the fundraiser is to illustrate to other churches that they can make similar efforts.

“We’ve been trying to encourage other congregations to get involved, and certainly other Episcopal churches in the diocese,” Nations said. “I think that’s probably what our next step will be, reaching out to Saint John’s in Montgomery, the Church of the Nativity in Huntsville or the Christ Episcopal Church in Tuscaloosa and saying, ‘If y’all are interested in looking for some way to make an impact in your part of the state, here’s how you can do it.’”

Something Everyone Could Agree On

Such fundraisers, Nations said, gives churches an opportunity to ameliorate a major issue in their communities without taking political sides.

“I don’t think anybody would deny that health care needs to be reformed, but clearly people have very strong opinions about what that should and should not look like,” he said.

“Saint Luke’s is a fairly decent-sized church, so on any given Sunday, you’ve got people in the pews who represent all parts of the political spectrum,” he continued. “I think this is a really good way of saying, ‘Look, we may have very different approaches to or understandings of this issue, politically speaking, but as Christian people we can all see a need when there is one, right?

“Health care reform is a huge topic and can sometimes feel intractable to someone who’s sitting in a pew,” Nations said. “But being able to do something like this made people feel like they were able to make a difference and move the needle in a positive direction. It’s been really inspiring for people in the parish.

“But it’s also helped to raise awareness of just how much of a catalyst medical debt in general can be for keeping someone trapped in poverty. It can really be a domino that falls and leads to a lot of other problems: hunger, homelessness, housing insecurity. We’re hoping that in some way, this debt forgiveness can be one step to help get these families back in a good place.”