Letters addressed to 134,000 Los Angeles County residents announcing their medical debt has been cleared are hitting mailboxes starting on Monday, May 19.

What undoubtedly will be the best news about unpaid medical bills these low-income residents receive, a notice sent to them and signed by the LA County Board of Supervisors, and showing the amount owed, is accompanied by this sentence: “We are writing to share the good news: You no longer owe the medical debt(s) listed to the right on this letter.”

How is this even possible?

First, the board approved the debt-relief program in December for residents who are four times (400%) below the federal poverty level or have medical debt that equals 5% or more of their annual income.

In short, the Los Angeles County Department of Public Health purchased the accounts from bill collectors, hospitals and other health systems for about $1.02 million and retired about $184 million in medical debt with no strings attached, the county reported. The county, along with its nonprofit partner, Undue Medical Debt, purchased the bills at a fraction of their face value, usually at about a half cent on every dollar.

The county has about $5 million in the fund for eliminating $500 million in medical debt, with more debt-retirement rounds to come. If the county can acquire donations from philanthropic groups, its goal is to reduce $2 billion in debt owed by nearly 882,000 adults in L.A. County — about 1 in 9 residents.

“There are thousands of people in our communities who could work for the rest of their lives and never get out from under the debt they incurred from seeking the care they needed. It’s absolutely crushing them,” said Supervisor Janice Hahn, who co-authored the motion for the program along with Supervisor Holly Mitchell.

Medical bills hanging over the heads of residents cause mental stress and set up choices between paying the bills and making rent or buying groceries. The bills only add to the already high cost of living in L.A. County.

The county reported that medical debt, even for people insured, has increased to 11.1% of L.A. County adults in 2023, up from 10% in 2022. Over half have used credit cards, often with high interest rates, to pay medical bills. Of those, 45% said they were unable to afford basic necessities. Some choose to skip medical care.

The burden of medical bills disproportionately impacts families with children, low-income households, and communities of color, including Latino, Black, American Indian and Pacific Islander residents, the county reported.

“Medical debt should never stand between our residents and the care they need,” said Mitchell. “We are committed to tackling the root causes of medical debt, so no one has to choose between seeing a doctor or putting food on the table.”

In September, the board adopted an ordinance aimed at preventing medical debt before it happens.

The board gave the Department of Public Health (DPH) the power to pore through data on patient medical debt, shining a light on what have been called secretive hospital practices at seven hospitals located within unincorporated L.A. County.

DPH has been sorting through data from bills that were sent to collection agencies, with the goal of finding errors or missed opportunities for patient financial assistance.

“We continue to work with hospitals and health care providers to improve the quality of financial assistance programs and debt collection practices so that those with limited means are not facing financial distress for seeking medical care,” said Barbara Ferrer, director of the DPH.

Residents getting hit with high or unexpected medical bills can go to: http://publichealth.lacounty.gov/hccp/medicalDebt/ for information on applying for free or discounted hospital services including charity care, legal advice, or counseling on dealing with bill collection.