Medical debt lawsuits across Minnesota have surged to the highest level in five years, according to a new analysis by independent nonprofit Pew.
When patients are unable to pay their medical bills and fall into debt, hospitals and health care providers often turn over that debt to collection agencies, and eventually they can be sued by the provider or a collection firm for payment. Lester Bird, a senior manager with Pew Charitable Trusts, said those lawsuits can come with financial repercussions such as having your wages garnished, and it can also have emotional consequences.
“The impact of having to go to court is huge, right?” Bird said. “People are scared that they might get arrested or go to jail for these unpaid debts. It's not true for the most part, but you know, this is the sort of fear people have.”
Minnesota has some protections in place, especially for low-income patients. In October, the Minnesota Debt Fairness Act took effect. It bans reporting medical debt to credit bureaus, prohibits denying necessary medical care to patients because of unpaid bills, and limits wage garnishment of low-income workers, among other reforms. But Bird said Minnesota courts could do more to weed out invalid cases brought against patients.
The Pew analysis, based on data from consulting group January Advisors and the National Center for State Courts, found that the number of medical debt lawsuits filed in Minnesota dropped significantly during the pandemic, but they have now surged back to pre-pandemic levels.
Lawsuits filed for overall consumer debt, including debt from unpaid medical bills, auto loans and credit cards, are also increasing — not just in Minnesota, but across the country. Some experts say these cases are possibly aided by artificial intelligence, which makes it easier for companies to analyze debt that is piling up and file lawsuits quickly.
David McClendon, a senior partner and consultant at January Advisors, said that medical debt cases are likely going up because hospital budgets are tightening, and because patients are no longer receiving pandemic stimulus payments that kept many of them afloat and out of debt in recent years. Hospitals may have also been trying to avoid bad optics when COVID-19 was spreading.
"Suing people during a pandemic was not a good look for a lot of hospitals,” McClendon said.
McClendon said that University of Minnesota’s Fairview Health Services is currently leading the increase in Minnesota, filing more than 4,000 medical debt lawsuits against patients with unpaid bills in 2024. He said Fairview is not only the biggest filer, it’s increasing its case numbers at the fastest rate.
A Fairview spokesperson told MPR News that litigation is only pursued in rare circumstances — roughly 1 percent of their clinical bill — and never against patients who have a clear inability to pay.
“We exhaust every possible option to support patients long before considering legal action,” the spokesperson said. “We also believe it’s important to recognize the broader forces driving patient medical debt. While hospitals are often the focus of scrutiny, many of the underlying challenges stem from payer practices — including high-deductible plans, denied or delayed claims and insufficient reimbursement rates — that leave patients caught in the middle.”
Mayo Clinic and Allina Health systems both received flack in recent years for suing patients over medical debt. McClendon said he doesn’t have any records of Mayo Clinic suing patients since 2023, and Allina Health’s lawsuits have gone down significantly since the negative media coverage.
McClendon said that one of the biggest hurdles is that patients might not even know to go to court when they’re sued. Sometimes the notice doesn't get to them, as it is sent to the wrong address; or, they assume it's spam because the letter came from a third-party debt collector they've never heard of. And, even if they want to fight the charge, McClendon said the hundred or so dollars it can cost in legal fees can be prohibitive.
"Most of these cases are for $1,200, $1,500. If people don't have $1,200 or $1,500, they don't have 200 or so dollars to be able to participate in the case in the first place. And so then what happens is that leads to people's wages being garnished and keeps people in this sort of cycle of poverty."
Bird said that as the number of these lawsuits increase, this is an urgent moment for legislators, policy makers and court leaders to take action.
He said he wants courts to act as more of a back stop, and confirm that the right person is being sued by the right company for the right amount before proceeding. Bird’s research indicates that many of these cases are inaccurate or missing crucial documents, and shouldn’t even be treated as valid. He also wants to make it easier for patients to defend themselves. Minnesota is a step ahead in this regard since it already requires that patients who successfully defend their lawsuit be compensated for any attorney fees incurred.
Even though it’s intimidating, Bird said he recommends patients go to court when they’re sued. They might be able to finagle a discount or a payment plan if they participate.
"These companies do negotiate with people,” said Bird, referring to the hospital or third-party debt collector. “There are fees that can be waived, but it requires a person to show up and engage in the lawsuit."
