‘I am a medical debt voter’: How a national nonprofit campaign is empowering NC voters impacted by medical debt

After losing his wife to cancer, North Carolina’s Terry Belk has spent years battling medical debt. Now, Community Catalyst is helping people like him make their voices heard at the polls.

As Charlotte native Terry Belk gave an interview from his home in August, a portrait of his late wife, Sandra, sat in the background on the dining room table.

Terry told Community Catalyst, a national nonprofit dedicated to advancing health justice, that life had taken  a devastating turn for the Belks in 2003, when Sandra was diagnosed with breast cancer. 

In addition to the frightening diagnosis, Terry soon realized that even with private health insurance, the couple would not have enough money to cover Sandra’s medical bills. A few months into her treatment, they were shocked to receive a $23,000 invoice from Atrium Health, the nonprofit hospital treating Sandra.

As the bills piled up, so did the pressure. Atrium Health pursued the couple relentlessly, with lawyers threatening court action to collect the debt. 

Feeling pressured without fully understanding what the hospital was demanding, Terry told NBC News in an interview that he agreed to what’s called a “deed of trust”—committing to  the hospital that they would receive $23,000 from the sale of the Belks’ home to cover the debt. 

“We weren’t trying to abscond from the bills,” Terry told NBC News. “I wanted to pay, but I couldn’t.”

The collection tactics took an emotional toll on Sandra, whose focus should have been on her recovery. “She said, ‘Why are they doing this to us?’” said Terry, remembering his wife’s words. “To us, that’s a lot of money, but to them, it was probably pennies.”

Months later, Sandra died, leaving Terry not only filled with grief but also facing unyielding debt. And in 2010, he received a diagnosis of his own—prostate cancer—and once again, he found himself facing a mountain of medical bills, with insurance only covering so much. 

History had repeated itself.

“I’m still paying on the prostate cancer bill,” he said. “And I am probably going to take this debt into the afterlife.”

The reality of medical debt is one that hits hard in the United States, where nearly 100 million people—about four in 10 adults—struggle with unpaid medical bills. Among those, about 11 million owe more than $2,000, and 3 million carry debts exceeding $10,000. 

For North Carolinians, the burden is especially heavy. Ranking fourth nationwide, North Carolina has one of the highest rates of medical debt in the country, with nearly one in five residents experiencing medical debt in collections as recently as 2022.

This is particularly impactful in rural areas, where communities of color bear a disproportionate share. 

Research shows that those with medical debt are more likely to delay or avoid necessary medical care, exacerbating health issues over time. For many North Carolinians already facing limited health care access and high costs, this cycle of debt and health decline highlights the need for immediate solutions.

READ MORE: Got medical debt in North Carolina? A new state program may help you.

That’s why Terry is part of a growing movement fueled by Community Catalyst, which recently launched its first Get Out The Vote initiative—the “I Am A Medical Debt Voter” campaign, which aims to mobilize those impacted by medical debt in key battleground states like the Tar Heel state, and emphasize the importance of electing policymakers who prioritize health and economic justice. 

“We have a medical debt crisis in this country and it’s more important than ever that those impacted by it have their voices heard at the ballot box and policymakers understand the urgent need to address this issue,” said Mona Shah, Community Catalyst’s senior director of policy and strategy, in a statement. 

In the first two weeks of the campaign alone, more than 400,000 people were reached through paid digital media.

“We have seen a tremendous response to this campaign in just a short period of time,” Shah said in a statement. “Never before has anyone organized this set of voters, but we believe this is a unique moment and that our elected leaders need to hear from the more than 100 million people affected by this crisis. We know this issue moves voters and those impacted most could be key voters in this election. Our organizing will ensure those who are living through this crisis can have an impact on the election.” 

For Terry, joining this movement is about more than his own experience—it’s about honoring Sandra and working for a future where others don’t face the same hardships.

“The only way that this is going to stop is if people speak up, speak out and advocate for better,” Terry said. “I’m in this because I lost the love of my life, and I feel her spirit with me every day. And I know that she wants me to stay in this fight, and I will.” 

Terry’s commitment is a testament to the urgent need for change. 

While health care systems, nonprofits, and policymakers have yet to fully address the impact of medical debt, individuals like Terry and organizations like Community Catalyst are pushing forward. 

And with the arrival of the 2024 election, the hope is to encourage voters to elect policymakers who will advocate for medical debt recipients, and prioritize solutions that prevent others from enduring what the Belks and many other Americans have experienced.

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