Delete WardMay 01, 2025
In a groundbreaking initiative, more than 160,000 Cleveland residents have had their medical debt erased, totaling over $165 million in debt relief. This success stems from a 2023 decision by Cleveland City Council to allocate $1.9 million in revenue recovery funds to partner with Undue Medical Debt (formerly known as RIP Medical Debt), launching one of the city’s most impactful public support programs.
“This was a modest investment by Council, just about .3% of the amount of the federal recovery money Cleveland received, that helped so many residents,” said Councilman Kris Harsh, who sponsored the legislation. “I’m grateful for the unanimous support of my colleagues to fund Undue Medical and proud that this initiative had a positive impact on so many Clevelanders.”
Surpassing Expectations
Originally designed to help approximately 50,000 residents, the program far exceeded expectations. In total, 161,481 individuals benefited, with $165,234,311.18 in medical debt eliminated. On average, each recipient had $1,023.80 in medical debt wiped away, though two individuals had about $250,000 eliminated. The median salary of those helped was $54,000.
Eligibility and Reach
To qualify, residents had to meet one of two criteria:
• Live in a household earning up to 400% of the federal poverty level, or
• Hold medical debt equal to 5% or more of their annual household income
Based on these thresholds, an estimated 80% of Cleveland residents were eligible.
How the Program Worked
Undue Medical Debt, which pioneered this approach over a decade ago, purchases bulk portfolios of delinquent medical debt—sometimes already listed for sale on secondary markets—from providers like hospitals and collection agencies. These debts are acquired for a fraction of their face value, meaning one dollar donated can relieve $100 of face value medical debt on average, or more. Instead of pursuing payment, they forgive the debt entirely, removing it from individuals’ credit reports, improving their financial outlook and access to credit.
Councilman Charles Slife, also a co-sponsor, shared, “The impact for our residents relieved a giant weight from the shoulders of tens of thousands of Clevelanders."
In Cleveland, five separate debt purchases were made on behalf of city residents, sourced from hospital systems and the secondary market (i.e., collection agencies). Residents did not, and could not, apply; those who qualified received a letter in the mail, branded from Undue Medical Debt, notifying them that some or all of their debt had been erased. Some residents are still receiving these letters as the final notifications are sent.
Spillover Benefits and What’s Next
One unexpected yet positive outcome was that when Undue purchased Cleveland-based debt portfolios, some $3 million in suburban residents’ debts were included. In these cases, city funds were used solely for Clevelanders, while private donations secured by Undue were used to forgive debt for suburban recipients.
As the program winds down, nearly $1 million remains unspent, and City Council is currently exploring options for how best to reinvest those funds for continued public benefit.
"Our goal is to use these remainder funds in ways that uplift, empower, and benefit the communities we serve," said Council President Blaine A. Griffin. “We believe that public dollars should work for the public good — and we're committed to making every cent count."
Broader Context
Cleveland’s success is part of a larger national effort to address America’s growing medical debt crisis. Nationwide, more than 100 million people struggle with at least $225 billion in unpaid medical bills, per the Kaiser Family Foundation. Undue Medical Debt alone has erased over $15 billion in medical debt to date for over 10 million families, and continues to expand its efforts with support from municipalities and philanthropic donors