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Yin on L.A. County Proposal to Erase Medical Debt

UCLA Luskin Public Policy Professor Wesley Yin spoke to the Los Angeles Times about a proposal by the L.A. County Board of Supervisors to purchase and forgive more than $2 billion in medical debt owed by constituents. A growing number of local and state governments have launched similar efforts to purchase such debt at a steep discount, relieving patients and their families of a heavy burden. Yin, who has researched the impact of these programs, said they are particularly beneficial if they erase debt early on, when patients are still working to pay it off. If L.A. County focuses on purchasing the cheapest debt, the kind of years-old medical bills that most people have long forgotten about, “it might not impact people’s financial situations that much anymore,” he said. In addition to debt forgiveness programs, solutions such as hospital financial assistance programs and health insurance expansions would help ensure that bills are paid more quickly, Yin said.


 

Yin on the Burden of Medical Debt in L.A.

Wesley Yin, associate professor of public policy at UCLA Luskin, spoke to LAist about the burdens of medical debt. In Los Angeles County, 1 in 10 adults are currently in debt due to medical care. Yin’s research shows that when hospitals wipe out patients’ debt and temporarily reduce how much they pay in co-pays, they are more likely to fill prescriptions and utilize health care resources. Yet within six months, even those whose debt was forgiven had returned to getting less care due to high costs. “Getting rid of medical debt may help in the short term, but a one-time cancellation doesn’t impact the future debts they may incur,” Yin said. He added that medical credit cards and other loans for medical bills can have high interest rates that deepen debt and threaten patients’ financial security.


 

Yin on Growing Efforts to Wipe Out Medical Debt

Wesley Yin, associate professor of public policy and economics, spoke to the New York Times about local governments’ efforts to address the high cost of health care by canceling their constituents’ medical debts. People with medical debt are less likely to seek needed care, and carrying a sizable debt load can damage credit and make it difficult to find employment, research shows. So across the United States, city and county officials are using funds from President Joe Biden’s American Rescue Plan to provide medical debt relief to eligible residents. Erasing this debt could be a “game changer” for some people, said Yin, who is studying the impact of medical debt relief programs on people’s livelihoods. He added, however, that governments should also address the root causes of medical debt, including high costs and limited access to good health insurance.


 

Yin on Policy Changes to Reduce Medical Debt

Associate Professor of Public Policy Wesley Yin was cited in a Health Care Journalism article about the burden of medical debt in the United States. Yin said that medical debt, totaling at least $140 billion, is the single largest source of consumer debt in the United States. To address this issue, the White House announced four steps to ease the burden of medical debt on health care consumers, including holding medical providers and debt collectors accountable for harmful practices and forgiving debt for low-income veterans. “Just shining a light on that type of behavior might lead to reducing the most egregious practices from providers,” Yin said. He expressed hope that the “White House’s actions to shine a light on charity care practices will have a positive effect for low-income individuals.” The policy changes may also “nudge providers to be stronger advocates for increased subsidies for health insurance and Medicaid expansion,” he said.


Yin on Burden on U.S. Medical Debt

Associate Professor of Public Policy Wesley Yin’s research into the soaring cost of medical debt in the United States was featured in the UCLA Anderson Review. A study co-authored by Yin and published in the Journal of the American Medical Association found that medical bills sent to collection agencies totaled an estimated $140 billion as of June 2020. That sum, which is bigger than all other sources of debt in collection combined, was tallied even before the pandemic saddled COVID-19 sufferers with unpaid doctor and hospital bills. Medical debt is concentrated in low-income neighborhoods, in the South and in states that refused to expand Medicaid coverage under the Affordable Care Act. “Communities that had been most burdened by medical debt have become even worse off, in absolute and relative terms, due to their leaders choosing not to expand Medicaid,” Yin said. “The results are important because they indicate that these problems are within the control of public policy.”

Manville on Heavy Burden of Rent Debt as Pandemic Drags On

An Orange County Register story on frustrations surrounding California’s rental assistance program, which made $5.2 billion available to help low-income tenants and their landlords during the COVID-19 pandemic, cited research led by the Lewis Center for Regional Policy Studies at UCLA Luskin. Surveys conducted in July 2020 and March 2021 found that, in Los Angeles County, renters’ debt rose sharply as the pandemic dragged on. Almost half of those surveyed in March turned to friends and family to help them pay rent, 58% dipped into their savings and 37% took out an emergency or payday loan, the study found. “That’s a lot of debt that people have accumulated, and they will be left out in the cold if we end up moving forward with a program that just pays your rent,” said Associate Professor of Urban Planning Michael Manville, co-author of the study. The research was also highlighted by Commercial Observer and Multi-Housing News.

Yin on National Burden of Medical Debt

Associate Professor of Public Policy Wesley Yin spoke to Verywell Health about the results of his research on the burden of medical debt in the United States. “Medical debt has become the largest source of debt and collections than all other sources combined,” Yin said, referring to recent research he co-authored that found 17.8% of individuals in the U.S. had medical debt in collections as of June 2020. “It just speaks to how important the expansion of Medicaid has been towards financial security, financial well-being, as well as reducing disparities in these communities,” he said. When medical bills are left unpaid, it can negatively impact an individual’s credit score and make it more difficult to qualify for loans. In order to curb medical debt, Yin recommended extending subsidies that would allow patients to purchase more affordable insurance plans with a smaller deductible. He also suggested expanding Medicaid, an approach that has been shown to reduce state spending.

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Study Measures Americans’ Growing Medical Debt

Over the last decade, medical bills have become the largest source of debt that Americans owe collection agencies, according to new research co-authored by Associate Professor of Public Policy Wesley Yin. The $140 billion in unpaid health care bills, held by about 18% of Americans, now exceeds all other debt in collections combined, according to the paper just published in the Journal of the American Medical Association (JAMA). Only debts referred to collection agencies were measured; other unpaid bills owed to health-care providers would push the total amount of debt even higher. Yin and co-authors Raymond Kluender of Harvard Business School, Neale Mahoney of Stanford University and Francis Wong of the National Bureau of Economic Research examined records from the credit rating agency TransUnion from January 2009 to June 2020, reflecting medical care delivered prior to the COVID-19 pandemic. Their comprehensive look at the evolution of medical debt reveals that, while Americans’ household finances largely recovered after the Great Recession, medical debt continued to grow. Yin said the debt was most concentrated in low-income communities and in the South. He added that, in 12 states that chose not to expand Medicaid coverage, significant disparities grew even worse during the period studied. “Addressing the problem of medical debt in the U.S. health care system must be a high priority,” said the authors of a JAMA editorial accompanying the study. “In addition to the potential consequences for health and health care use, the economic and social ramifications of medical debt are likely equally consequential, if not more so.”


 

UCLA Report Highlights Inequality in Utility Debt Burden

Scholars from the UCLA Center for Neighborhood Knowledge (CNK) and UCLA Luskin Center for Innovation (LCI) collaborated on the new report “Keeping the Lights and Heat On: COVID-19 Utility Debt,” which analyzed the burden of household utility debt for many families, especially in low-income neighborhoods. The report, co-authored by CNK Director Paul Ong and LCI Associate Director Greg Pierce, used data from Pacific Gas and Electric Company (PG&E), an investor-owned utility that provides electricity and gas service to about 40% of California residents, in order to quantify the prevalence and degree of residential past-due accounts and debt. The authors explained that utility debt levels serve as a useful proxy to track households that are facing difficulties paying their rent or mortgage, particularly during economic crises. While roughly 6% of the Northern and Central California households served by PG&E are facing financial difficulties paying for most essential services, utility debt burden is highest among Black, Latino and economically vulnerable neighborhoods, the study found. PG&E recently announced that it will extend a moratorium on utility service disconnections through September 30, although many other emergency customer protections put in place during the COVID-19 pandemic have expired. The authors of the report recommend allocating funding to debt-forgiveness programs for low-income households and severely impacted neighborhoods. They plan to replicate the study in non-PG&E service areas  to better understand the impact of energy and water bill debt across regions. — Zoe Day


Report Documents Struggle to Keep the Lights and Water On

A Grist article highlighted the findings of a UCLA Luskin report about the impact of the COVID-19 pandemic on utility debt, particularly in communities of color. Scholars from the UCLA Luskin Center for Innovation and Center for Neighborhood Knowledge co-authored the report, including CNK Director Paul Ong, LCI Associate Director Greg Pierce, senior researcher Silvia González and graduate research fellow Ariana Hernandez. The paper, “Keeping the Lights and Water On: COVID-19 and Utility Debt in Los Angeles’ Communities of Color,” evaluates utility debt levels to measure residents’ difficulty paying rent during the pandemic. They found that one-quarter to one-third of households in Los Angeles have utility debt, but Black, Latino and lower-income neighborhoods are most severely impacted, as well as renters and people with limited English proficiency. The authors recommended developing and implementing debt-forgiveness and relief programs in order to support low-income households and severely burdened neighborhoods.