A campaign in Cuyahoga County, Ohio erased approximately $1.3 million in medical debt for 1,148 county residents through a partnership with Undue Medical Debt, a nonprofit that purchases bundled medical debt at secondary-market rates and cancels it. The campaign was led by Ethan Khorana, a 20-year-old Duke University student from Shaker Heights who raised roughly $10,000 from donors to buy the debt portfolio—a price that reflects the typical economics of medical-debt secondary markets, where bundled debt sells for pennies on the dollar. The relief arrived by mail to affected residents with no tax consequences, strings attached, or requirement to apply. In Cuyahoga County, roughly 10% of the 1.2 million residents carried medical debt in collection agencies in 2022, averaging $440 per person, according to Urban Institute estimates cited in News 5 Cleveland reporting.
Table of Contents
- How Medical-Debt Relief Works
- Who Was Affected and How Much Was Erased
- The Campaign Behind the Relief
- What the Relief Means and What It Does Not
- Medical Debt as a County Problem
- Frequently Asked Questions
How Medical-Debt Relief Works
Undue medical debt identifies and purchases medical debt portfolios sold in bulk by hospitals and healthcare providers who have written off the accounts as uncollectible. The debt originates from unpaid bills—emergency visits, surgeries, ongoing treatments, and diagnostic procedures that patients could not afford.
Rather than pursue collection actions, hospitals often sell these bundled accounts at a deep discount on the secondary market. Undue pays a fraction of face value and immediately erases the debt, with no attempt to collect from the beneficiaries. The selection process is data-driven: Undue analyzes income and debt-to-income ratios to target households most likely to benefit from relief.
Individual residents cannot apply for the program—they are identified through the data and notified by mail that their debt has been purchased and forgiven. Undue Medical Debt reports that it has eliminated over $10 billion in medical debt nationally, funded entirely by donations from individuals and organizations.
Who Was Affected and How Much Was Erased
The 1,148 Cuyahoga County residents who received debt cancellation carried balances that had landed with collection agencies or were in default status. The total debt erased was approximately $1.2 to $1.3 million, meaning the campaign's $10,000 in donations purchased roughly $120–130 in relief for every dollar raised—a ratio that illustrates how severely discounted medical debt is on the secondary market.
The residents were spread across multiple hospital systems and providers in the county. According to News 5 Cleveland, the debt came from various local hospitals and was acquired through Undue's standard process of purchasing bulk portfolios. No public list of affected individuals is available due to HIPAA restrictions protecting patient privacy.
The Campaign Behind the Relief
Ethan Khorana, a public policy major at Duke University, founded The Better Future for Cuyahoga to address poverty, violence, and discrimination in the county. His medical-debt campaign was one initiative under that organization's broader mission. Rather than waiting for systemic change, Khorana mobilized a small group of donors to raise the $10,000 needed to purchase the debt portfolio, demonstrating how grassroots funding can translate into immediate relief at scale.
According to Scripps News, Khorana's effort highlights the power of secondary-market debt acquisition as a relief strategy. While this approach erases existing debt rather than preventing new medical bills, it provides immediate help to households already struggling under collection accounts and shows what private philanthropy can achieve when paired with organizations designed to execute debt relief at volume.
What the Relief Means and What It Does Not
The debt cancellation removes collection accounts from credit reports and halts collection calls and notices for affected residents. It does not reverse credit damage that already occurred—accounts that were reported to credit bureaus during delinquency may remain on credit reports for up to seven years after the account is closed, though the notation typically improves once the debt is paid or satisfied.
The relief also does not change the underlying cost of medical care. The $1.3 million erased represented past bills; future medical debt is still a risk for the same households unless they gain insurance coverage, access to charity care programs, or income growth. Undue pairs debt relief with policy advocacy aimed at hospital financial-assistance programs and reducing future medical debt generation, but individual relief does not prevent new medical bills from accumulating.
Medical Debt as a County Problem
Medical debt is widespread in Cuyahoga County. The 10% of residents carrying collection-agency medical debt—roughly 120,000 people at 2022 estimates—faced an average balance of $440, meaning the total medical debt in collection county-wide was tens of millions of dollars. The 1,148 residents relieved by this campaign represent roughly 1% of those carrying medical debt. Hospitals in the county operate under varying financial-assistance policies.
Some offer charity care to uninsured patients; others require proof of income. Undue's approach complements but does not replace hospital-based assistance. Residents facing medical debt who have not applied for hospital payment plans or charity care programs should contact their healthcare provider's billing department before accounts are sold to collection agencies—assistance programs can often retroactively adjust bills or erase them entirely.
Frequently Asked Questions
How did my debt get erased if I did not apply?
Undue Medical Debt identified your account through data analysis of income and debt-to-income ratios, purchased your debt from a hospital or healthcare provider, and immediately canceled it. You cannot apply for the program—selection is automatic based on financial criteria.
Will I owe taxes on the forgiven debt?
No. Debt forgiven through Undue Medical Debt is not reported as taxable income to the IRS, so you will not face a tax bill for the relief.
Does this help my credit score?
It stops future collection activity and allows accounts to be marked as paid or satisfied, which can improve your credit over time. However, negative payment history already reported to credit bureaus may remain on your credit report for up to seven years.
What should I do if I still have medical debt?
Contact your healthcare provider's billing department to ask about payment plans, financial-assistance programs, or charity care. Many hospitals will reduce or forgive bills for uninsured or low-income patients before selling the debt to collection agencies.