Local governments in the US are beginning to work with RIP Medical Debt, a nonprofit group that uses private donor funds to buy up and pay off peoples’ health care debts, says a story that is part of Diagnosis: Debt, a reporting partnership between KFF Health News and National Public Radio that explores the scale, impact, and causes of medical debt in America. An estimated 100 million people in the US carry some form of health care debt.

In 2022, Cook County became the first local government to do so, after two staff members suggested to Toni Preckwinkle, president of the county board of commissioners in Cook County, Illinois, that the county could spend part of its federal pandemic rescue funds to relieve residents’ medical debt. The county is now in the process of spending $12 million — a tiny portion of its budget — to ultimately retire $1 billion worth of hospital bills for residents.