Medical debt continues to devastate millions of Americans, with many seeing their paychecks garnished even when laws are meant to protect them. Across the U.S., patients are losing wages to cover medical bills — some of which should have been covered by Medicaid or charity care programs.
Medical Debt Leading to Wage Garnishment
In Colorado, thousands of workers have faced wage garnishment over unpaid medical bills. Court records show patients being pursued for debts ranging from as little as $30 to more than $30,000. While most balances started under $2,400, interest and court fees often added 25% or more. In some cases, debts ballooned by over 400%.
These cases followed people for years — even over a decade — as debt collectors revived lawsuits while workers moved jobs. Hospitals, physician groups, ambulance providers, and even nonprofit health systems were among those seeking garnishment. Alarmingly, some hospitals garnished the wages of their own employees for unpaid bills from the same facility where they worked.
States Allowing Wage Garnishment for Medical Bills
Colorado is one of 45 states that permit wage garnishment for medical debt. Only Delaware, New York, North Carolina, Pennsylvania, and Texas prohibit the practice. Advocates argue that taking wages from low-income workers only worsens financial instability rather than resolving debt.
National consumer health groups warn that the issue is likely to grow as millions lose health insurance coverage due to Medicaid changes and potential cuts to Affordable Care Act subsidies. Without coverage, medical emergencies can quickly spiral into unmanageable debt.
The Hidden Burden of Medical Debt
Medical debt often remains invisible because it’s bundled with credit card or payday loan debt. Many patients also feel shame, making the problem less visible in public discourse. But studies show nonprofit hospitals are among the most aggressive in garnishing wages.
In Virginia, research revealed that 36% of hospitals — mostly nonprofit — pursued garnishment, disproportionately targeting low-wage workers. Similar patterns have been documented in other states.
The Impact on Families
For families already struggling, garnishment often means choosing between basic needs. Workers reported falling behind on rent, utilities, and food while paying off hospital bills. In Colorado, patients wrote to judges explaining that losing 20% of their disposable income could lead to losing everything.
In one case, a preschool teacher’s wages were garnished even though Medicaid should have covered her daughter’s emergency ambulance ride. Another patient had her wages withheld for over $10,000 in hospital bills while being showcased on her hospital’s website as a model employee.
Consumer Protections and Limitations
Colorado law provides some protections, such as limits on monthly payments tied to income and debt forgiveness after three years of installments. However, if patients don’t agree to a plan, up to 20% of their disposable earnings can be taken. Advocates warn that these protections are inconsistently enforced.
Debt collectors argue garnishment is a last resort, but patients often face lawsuits they don’t know how to contest. Most cases end in default judgments, meaning patients didn’t appear in court — often because notices were missed, mistaken for scams, or too overwhelming to fight.
Errors and Medicaid Misbilling
Adding to the crisis, many garnishment cases involve errors. Colorado’s Medicaid office reported sending out 11,000 correction letters in one year to stop illegal collections from patients whose bills should have been covered. Still, patients often endure months of financial stress before debts are corrected.
Experts warn the complexity of U.S. medical billing makes errors common. With no centralized system for verifying Medicaid coverage, debt collectors often pursue patients incorrectly.
A System That Favors Collectors
Debt collection companies file the majority of lawsuits, not hospitals directly. The process is fast, inexpensive, and designed for efficiency — allowing companies to mass-produce lawsuits. For patients, however, contesting errors is time-consuming, expensive, and overwhelming.
While wage garnishment accounts for only 0.2% of hospital revenues, the consequences for families are devastating: lost income, shut-off utilities, food insecurity, and long-term credit damage.
Conclusion: Medical Debt Crisis Demands Reform
Medical debt wage garnishment highlights the imbalance between health providers and vulnerable patients. While hospitals and collectors frame garnishment as a necessary financial tool, advocates argue it traps families in deeper poverty.
With health insurance coverage expected to decline in the coming years, more Americans may find themselves caught between medical emergencies and financial ruin. Stronger consumer protections, debt forgiveness policies, and systemic health care reform are increasingly seen as essential to prevent medical debt from destroying livelihoods.
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