Sleepless nights over her children’s future as debts pile up

My doctor saved my life, but my medical bills are stealing my children’s lives.”

Jeni Rae Peters

Jeni Rae PetersAge 44, Rapid City, South Dakota

Approximate medical debt: Over $30,000

Medical problem: Breast cancer

What happened: Jeni Rae Peters’ budget has always been tight. But Peters, a single mother and mental health counselor, has worked hard to provide opportunities for her children, including two daughters she has adopted and a succession of foster children. One of her daughters was homeless.

Then, two years ago, Peters was diagnosed with stage 2 breast cancer.

Multiple surgeries, radiotherapy and chemotherapy controlled the disease. But, despite having insurance, Peters ended up with more than $30,000 in debt and mounting threats from debt collectors.

A collection call came as Peters lay in the recovery room after her double mastectomy. “I was a little delirious and thought it was my kids,” she said. “It was someone asking me to pay a medical bill.”

During surgeries and treatments, Peters continued to work so as not to lose his confidence. She took on extra work to pay some bills. Five days a week, she works consecutive shifts at both a mental health crisis center and a clinic where she counsels teenagers, some of whom are suicidal. Last year, three east coast friends paid off some of the debt.

But Peters’ credit score has fallen below 600. And she constantly worries about how she will support her children.

Peters said she might drop car insurance for her teenage daughter, who just got her license. Canceling ice skating for another girl would bring in an extra $60 a month. But Peters is reluctant. “Do you know what it’s like to be an adopted child and get a gold medal in ice skating? Do you know what kind of citizen they could become if they know they’re special? ” she says.

Peters added: “My doctor saved my life, but my medical bills are stealing my children’s lives.”

What is broken: Despite many advances in cancer treatments, millions of Americans find themselves in debt after being diagnosed with the disease.

This is partly because drugs and treatments are now so expensive. It’s also because health plans typically require patients to pay thousands of dollars out of pocket in deductibles and other shared costs.

One study found that cancer patients were 71% more likely than unaffected Americans to have bills in collection or to have a credit account closed for nonpayment.

Debt forces many to make difficult sacrifices. According to a survey conducted by KFF for this project, two-thirds of American adults who incurred health care debt and had cancer themselves or in their family reduced their spending on food, clothing or other health care products. household basis. One in four people have declared bankruptcy or lost their home.

The financial stress of debt can hinder cancer patients’ recovery and even hasten death, researchers have found.

What’s left: Peters’ cancer is in remission and his health has improved. She said she was thrilled to adopt two more of her foster children.

But threats from debt collectors keep coming. She recently received a new collection notice for $13,000, warning her that she would soon face legal action.

Peters said she had no way to pay off all of her debts. She recently told a bill collector that she was ready to go to court and ask the judge to decide which of her children should miss extracurricular activities to pay off their debt.

She asked another debt collector if he had children. “He told me that I had chosen to have surgery,” Peters recalled. “And I said, ‘Yeah, I guess I chose not to be dead. “”

About this project

“Diagnosis: Debt” is a reporting partnership between KHN and NPR exploring the scale, impact and causes of medical debt in America.

The series is based on the “KFF Health Care Debt Survey”, a survey designed and analyzed by KFF public opinion researchers in conjunction with KHN journalists and editors. The survey was conducted from February 25 to March 20, 2022, online and by phone, in English and Spanish, among a nationally representative sample of 2,375 American adults, including 1,292 adults with health care debt. and 382 adults with health care debt in the past five years. The margin of sampling error is plus or minus 3 percentage points for the full sample and 3 percentage points for those with current debt. For results based on subgroups, the margin of sampling error may be higher.

Additional research was conducted by the Urban Institute, which analyzed credit bureau and other poverty, race, and health status demographics to explore where medical debt is concentrated in the United States and what factors are associated with high debt levels.

The JPMorgan Chase Institute analyzed the records of a sample of Chase credit cardholders to examine how customer balances can be affected by large medical expenses.

Reporters from KHN and NPR also conducted hundreds of interviews with patients across the country; spoke with doctors, healthcare industry leaders, consumer advocates, debt lawyers and researchers; and reviewed dozens of studies and surveys on medical debt.

This article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health policy research organization not affiliated with Kaiser Permanente.