Americans shoulder a lot of debt. When it comes to past-due medical bills, the country collectively owes at least $81 billion, according to a 2018 Health Affairs study. One in six has a credit report tarnished by debt owed to someone who probably wears a white coat to work (or to that someone’s boss).

But there’s a new trend among American churches that’s taking aim at the mess. Over the past two years, more than a dozen congregations have partnered with a debt forgiveness organization to cancel millions in medical debt for people in their communities.

Pathway Church in Wichita, Kansas, spent a $22,000 chunk of its budget partly meant for publicizing its Easter services to eliminate $2.2 million in medical debt for local residents. Emmanuel Memorial Episcopal Church in Champaign, Illinois, used a $15,000 surplus from a building renovation project to eliminate $4 million of debt for more than 3,000 families.

Revolution Annapolis, a small Maryland church that doesn’t even have its own building, collected $15,000 last December. That donation wiped out $1.9 million for nearly a thousand families in a dozen surrounding counties. City Church in Evansville, Indiana, raised $15,000 to cover $4 million in debt.

Each of these campaigns was done through a nonprofit called RIP Medical Debt, which buys huge bundles of medical debt for cheap and then invites charitable donors—such as churches—to settle the bill. Once the donations are in, RIP sends letters to the debtors, alerting them that their bill was paid in full.

“Taking up debts, helping to relieve each other’s burdens . . . that’s a fundamental image of Christian discipleship,” said theologian Jordan J. Ballor, senior research fellow at the Acton Institute. “I think in a broad sense, this is a wonderful expression of the body of Christ caring for itself.”

The Bible has a complex but realistic view of debt. From a divine perspective, God created us; we owe him everything. Here on earth, lending and owing is a regular pattern of life, with Paul telling the early church to “give to everyone what you owe them” (Rom. 13:7).

Ballor sees that as an acknowledgment that loans and debts are normal and can serve as an expression of how justice works. “Good will come to those who are generous and lend freely,” according to Psalm 112:5.

But today’s debt-buying world is complex and can get seedy. Even the medical billing process raises questions. If collection agencies can buy debt bundles for pennies on the dollar, are hospitals just brazenly overcharging?

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Since hospitals and other providers often have millions in unpaid bills every year, they are desperate to recoup their losses, explained Joe Antos, a scholar in health care policy for the conservative American Enterprise Institute (AEI). After exhausting every available means to get patients to pay, they can either take the hit or sell the debt for dirt-cheap to a third party, which then forges its own quest for repayment.

Because those third parties often buy the debt at such a steep discount, there’s a huge profit margin up for grabs if they’re successful. RIP wants to disrupt that process.

Still, Antos thinks buying and forgiving debt is a bad move for churches. “This is not something amateurs should try,” he said. “Churches that do not operate in a businesslike way will find themselves in financial trouble.”

Ballor disagrees. While all debts aren’t morally equal (loans for survival aren’t the same as loans for sports cars), he still sees the act of paying another’s debts as an apt reflection of Jesus’ sacrifice.

And paying medical debt acknowledges another theological reality: “We’re not just called to care about souls,” he said. “We’re also bodies. If you understand suffering as a consequence of the Fall … we are called to ameliorate it to the extent that we can.”

Jeff Kinkade, pastor of City Church Evansville, proposed the idea of doing a debt payoff campaign to his nondenominational congregation last year. He said it could be a way to glorify the name of Christ at a time when American Christianity’s reputation is taking a bit of a beating.

It only took around three weeks for about 500 weekly attendees to raise $15,000 through a special offering. Their donation covered more than 250 times as much in medical debt.

Over the summer, the Trump administration moved toward new requirements around price transparency. Christians in healthcare have also been working to empower patients to manage a complicated system and the rising costs that come with it.

Mercy Hospital Northwest Arkansas, a Catholic health care group, gives away more than $20 million in free health care each year through its charity care system. Patients who qualify don’t even see a bill. Mercy absorbs at least that much from patients outside the program who can’t or won’t pay. That means its unpaid medical bills would never show up on RIP Medical Debt’s ledger.

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Chad Raith, vice president of mission at Mercy, commended churches for paying off medical debt but said the problem is bigger than unpaid bills. “Let’s say you have an ailment, and really you just need to go to your primary care, but you decided to go to the ER,” he said. “Well, you just inflated your bills by ten times.” One answer is for churches to not just pay bills but help communities approach their healthcare more wisely.

Antos at AEI also raised the issue of health literacy. He was concerned that churches paying off medical debt might become inadvertent victims of fraud, especially if RIP doesn’t confirm the debt they buy was correctly billed.

RIP Medical Debt was founded by two former collections industry executives who had a change of heart during the Occupy Wall Street movement. It’s not officially a Christian organization, but cofounder and director of debt operations Craig Antico is a believer. He said he was looking for his higher purpose in God when he helped start the nonprofit, which grew out of a now-defunct venture called the Rolling Jubilee. That group aimed to forgive all kinds of debt, like in the Old Testament “jubilee year.”

RIP, incorporated in 2014, only pays off medical debt. It got off to a slow start, only raising about $3,000 in its first year. After comedian John Oliver paid off nearly $15 million in medical debt through RIP for his HBO show, its budget shot up. It has since covered more than $700 million in American medical debt, and churches are on their way to becoming the largest donor block.

RIP purchases debt from other debt buyers—ones its founders know and trust—not healthcare providers. But since they do not independently check for fraud, it’s possible they overpay at times, Antico said. And churches that give to RIP assume that risk as well.

But Christians know the weight of a debt they cannot repay and the signficance of a Savior who graciously covers even those who betray him. As City Church wrote in a note to each of the local recipients: “We may never meet, but as an act of love in the name of Jesus Christ, your debt has been forgiven.”

Maria Baer is a freelance writer based in Columbus, Ohio.

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