In an effort that could offer significant financial relief to many San Antonians, District 9 Councilmember John Courage announced a new partnership with the non-profit organization Undue Medical Debt. According to details shared on the City of San Antonio's website, the collaboration stands to eliminate approximately $60 million worth of medical debt for about 45,000 residents in San Antonio. As the project rolls out, selected individuals will find out via mail that their medical debts have been paid off.
Texas faces significant challenges related to medical debt, with Bexar County ranking third among the 20 largest counties for residents impacted by this issue. This program aims to address the financial strain experienced by many in the community. Councilmember Courage noted that the high rate of uninsured and underinsured individuals in Texas, along with the state's decision not to expand Medicaid, has contributed to the severity of the problem.
Backing for the medical debt relief comes from the City Council-approved 2025 Budget, with $115,000 in funding earmarked from District 9's discretionary funds. This is the first instance of Undue Medical Debt joining forces with a Texas government entity. As described by Councilmember Courage, "This program is about giving people relief—and restoring dignity," highlighting its focus on providing financial support and promoting a sense of respect and self-worth for those affected.
Beneficiaries of this initiative will be determined based on income and the extent of their medical debt—selecting individuals who either earn at or below 400% of the federal poverty level or for whom medical debt equals or exceeds 5% of their annual income. Unlike conventional assistance programs, recipients are chosen through sourced-based methods without the need for an application process. The program leverages the City’s investment to purchase medical debt from providers and the secondary market at a fraction of the nominal value, enabling a large impact for each dollar spent. The unexpected letters arriving in branded Undue Medical Debt envelopes will inform recipients of their debt relief in the weeks ahead.
This effort reflects an urgent response to a national crisis, as emphasized by Councilmember Courage on the city's website, stating, "Medical debt is the leading cause of bankruptcy in the United States, and so many families are one illness or emergency room visit away from financial ruin." This debt relief program offers both immediate economic assistance and sets a precedent for other municipalities to consider as they tackle the widespread issue of medical debt in their communities.
