North Carolina erases more than billion in medical debt for 2.5 million residents
Medical debt relief in North Carolina just made history. The state erased more than billion in medical debt for roughly 2.5 million residents — about one in four people — making it the largest state-level debt relief effort of its kind in U.S. history. Funded through savings from North Carolina’s 2023 Medicaid expansion, the 40 million investment leveraged a nonprofit debt-purchasing model to cancel bills at a ratio exceeding 40-to-1. No application was required — relief simply arrived. The program offers a replicable model for other states and demonstrates what’s possible when political will meets creative fiscal policy.









