A 20-year-old college student from Shaker Heights spent just two months raising a little over $10,000 and, in doing so, helped cancel $1.3 million in medical debt for 1,148 Cuyahoga County residents. Ethan Khorana, a sophomore public policy major at Duke University, partnered with the nonprofit Undue Medical Debt to pull off the campaign, leveraging the group's ability to buy up unpaid medical bills at steep discounts on the secondary market.
The math behind the campaign is what made it possible on such a small budget. As reported by Cleveland Scene, hospital systems routinely sell medical debt in bulk to collection agencies and other buyers, and Undue Medical Debt uses that same secondary market to acquire and cancel it instead. According to the outlet, Undue Medical Debt has reported that every $1 raised can translate into $100 in medical debt canceled, which is how Khorana's roughly $10,000 haul ballooned into $1.3 million in relief for 1,148 people.
“Ten thousand dollars can fundamentally change people's lives and how they move forward from a bill,” Khorana said, per the same account. He also said he was surprised that he had to be the one doing it, a comment that points to a gap left by larger institutional efforts even as local governments have poured millions into similar work.
A Track Record Before Medical Debt
Khorana's push into medical debt relief did not come out of nowhere. He began organizing in Shaker Heights at age 14, co-founding the Minorities Together Movement and later receiving the 2021 Princeton Prize in Race Relations for youth-led civil rights work, according to Princeton University. In late 2023, as a 17-year-old student activist, he helped coordinate the campaign that made Shaker Heights the third jurisdiction in the country to restrict non-safety pretextual traffic stops, per the Vera Institute of Justice.
Khorana also helped raise $20,000 for Shaker Heights police mental-health co-responders and assisted with Mayor Justin Bibb's transition into office in 2023, Cleveland Scene reports. He plans to return to Cleveland after finishing his Duke degree in 2028 to pursue data-driven policy ideas, and he has said he may look into canceling other types of debt beyond medical bills.
How Cuyahoga County's Debt Problem Took Shape
The scale of the underlying problem in Cuyahoga County, which has 1.2 million residents, helps explain why Khorana's contribution mattered even at a relatively modest dollar amount. About 10 percent of county residents carried some medical debt in 2022, with a median debt amount of $440, according to the Urban Institute dashboard cited by Cleveland Scene.
Khorana's private fundraising followed a much larger public effort. Cleveland City Council allocated $2 million of American Rescue Plan Act dollars in 2025 toward its own medical debt relief partnership with Undue Medical Debt, which the council says helped erase $165 million in combined medical debt for 161,000 Clevelanders. Ward 4 Councilman Kris Harsh spearheaded that campaign, and Signal Cleveland reported that roughly $1 million of the allocated ARPA funds went unspent when the program concluded in May 2025, a shortfall tied to qualifying criteria and hospital portfolio availability.
MetroHealth, Northeast Ohio's public health system, ran a parallel partnership with Undue Medical Debt that it says erased over $200 million in medical debt for 290,761 local patients, including $136.8 million for Cleveland residents funded through the city council's federal allocation, according to Undue Medical Debt. That gap between what large public programs can reach and what remains left over is exactly the space Khorana's grassroots effort stepped into.
Regional Momentum and Nonprofit Backing
Marisa Clemente, Undue Medical Debt's vice president of philanthropy, said the campaign showed what is possible when a community comes together. The Boston-based nonprofit, founded in 2014 by former debt collection executives under the name RIP Medical Debt, had eliminated more than $25.4 billion in medical debt for over 15.2 million people nationwide as of February 2026.
Ohio has become something of a testing ground for this model. Toledo and Lucas County were early pioneers, combining $1.6 million in federal ARPA and county funds in late 2022 to erase over $230 million in medical debt for more than 112,000 area residents, according to the City of Toledo. More recently, in March, the City of Akron erased nearly $20 million in medical debt for 17,000 residents by spending $115,000 through Undue Medical Debt, an effort spearheaded in part by two Northeast Ohio Medical University students, as Hoodline reported in its piece on the Akron debt wipeout.
State lawmakers have also taken notice of the underlying problem. Ohio Representatives Michele Grim and Jean Schmidt introduced bipartisan legislation in May 2025, House Bill 257, the Ohio Medical Debt Fairness Act, which would cap medical debt interest rates at 3% annually and restrict predatory collection practices statewide, according to the Ohio House of Representatives. That effort comes against a shifting federal backdrop: a federal district court in Texas vacated a Consumer Financial Protection Bureau rule that would have banned medical bills from credit reports nationwide, leaving reporting rules governed by voluntary credit bureau policies and state-level restrictions, per Midwest Service Bureau.
Nationally, more than 100 million people in the United States carry unpaid medical bills, according to Kaiser Family Foundation data reported by Axios, underscoring why healthcare costs remain a leading driver of personal financial instability. For Khorana, the two-month campaign is a small dent in that larger crisis, but one he says proves what a determined individual effort can still accomplish while bigger institutional programs work out their own limits.
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