I work in a small, private practice in Minnesota. My colleagues and I have been deeply affected by the recent approval of the MN Debt Fairness Act. This act, though developed with good intentions, poses a significant threat to the existence of small practices and clinics across the state. 

In March of this year MN Legislators signed a bill that included the Minnesota Debt Fairness Act. This bill will bring many reforms to medical debt and collections efforts. 

These new statues include a myriad of changes to how debt is collected in the healthcare sector. This includes eliminating the transfer of medical debt to the patient’s spouse, requiring practices to post billing practices, and barring medical debt from being reported to credit bureaus. These items bring positive change to medical billing but there are other statues that were added without the proper planning to sustain them. 

Our concern specifically lies with the new Minn. Stat. 62J.806, 332C.02 and 332C.05. On the surface these statues promise that patients can’t be denied care due to outstanding debt and establishes new strict guidelines for how debt may be collected by medical practices. 

At a glance, this bill sounds like it could have a profoundly positive impact for MN residents by allowing them to live without the fear or burden of medical debt. But in reality, removing the repercussions of medical debt without any plan established to help the providers and facilities providing medical services, could bankrupt our state healthcare system.

While no patient wants to think of medicine as a business, the reality is that there are costs associated with providing care that cannot be ignored. How these statutes are written allows patients to receive ongoing care without paying their debt, essentially allowing for free care to be provided to every patient.

In a perfect world, all humans should have access to free, thorough healthcare. However, this bill is not providing that. What this will actually accomplish is forcing providers to continue providing care indefinitely to anyone regardless of whether they can pay at all. Without the payment for services this will mean facilities cannot pay their staff, providers, or operating expenses. Small group practices will most likely be the first to see the effects of this change, causing them to close their doors, but this will be detrimental to all facilities within the state as more people refuse to pay for their care.

Our state is already at a widespread deficit staff in the healthcare sector. In 2023 the Minnesota Hospital Association (MHA) cited a report substantiating a financial crisis for the state’s healthcare industry with many hospitals announcing layoffs of hundreds of employees. With Medicare/Medicaid being responsible for over $2 billion in underpayments within the state, our hospitals are already struggling to stay afloat. Inflation also effects the costs of supplies, medications and labor, leading to further financial burden for facilities.

Putting financial factors aside, we have been at a provider and staff deficit exacerbated by the pandemic. In 2023, the state’s healthcare institutions had a worker vacancy rate of around 17% and over 45,000 health-related job openings across the state. Healthcare professions are also among the highest rates of burnout with rates as high as 56% reporting burnout (among US nurses), and 45.6% of all healthcare workers reported feeling burnout often or very often in 2022.

Understaffing, inadequate compensation, and lack of job security are issues already rampant in the healthcare industry. The additional stress on facilities once they are not reimbursed for care provided will exacerbate these existing problems. Potential closures will also displace many workers, causing increase in unemployment rates statewide while simultaneously making quality care more rare.

This first practices that will feel the effects of these changes will be small group and private practices. These practices often do not receive any outside funding and are small businesses that rely on payment for services to keep their doors open. These practices are also the most likely to provide personalized care and operate with much smaller profit margins.

While I do not disagree with the intentions behind this Act, I cannot ignore the fact that how it is written allows for abuse of these allowances and steps were not taken to balance these changes. Considering the grave implications of this act, we call on the Minnesota state legislators to seriously consider repealing the MN Debt Fairness Act of 2024. Please sign this petition and stand with your healthcare providers to demand for a solution that balances the provision of accessible healthcare with fair remuneration for the providers.