January 31, 2020

Senator Warren Questions DoD and Treasury's Aggressive Collection Practices for Debts Incurred in Military Hospitals and Medical Centers

Civilians treated at DoD facilities risk having wages, tax refunds, and even Social Security benefits withheld; "No American should struggle to access health care or be forced to take on debt in order to get the care or coverage they need"

Text of Letter to DoD (PDF) | Text of Letter to Treasury (PDF)

Washington, D.C. -- United States Senator Elizabeth Warren (D-Mass.), a member of the U.S. Senate Armed Services Committee (SASC) and Ranking Member of the Senate Banking, Housing and Urban Affairs Subcommittee on Financial Institutions and Consumer Protection sent letters to the Department of Defense (DoD) and the Treasury Department requesting more information about the collection of military hospital debt from low-income, civilian patients and asking whether their collection practices may be disproportionately affecting vulnerable Americans, including the uninsured, low-income families and individuals, and those receiving Social Security benefits.

DoD operates a nationwide network of fifty-one hospitals and medical centers. Civilians can also receive treatment at these facilities if they have a severe injury in an underserved area, or when a military hospital is uniquely equipped to handle treatment. At one military hospital, up to eighty-five percent of trauma patients are actually civilians in need of emergency care; these civilians may not even know that they are going to a military hospital if they are transported there during an emergency.

The billing and debt collection practices used by military hospitals differ from civilian hospitals. Some military hospitals do not bill a patient's insurer, leaving it up to the patient to file a claim for coverage. In addition, DoD regulations require military hospitals to take "prompt and aggressive action" to collect their debts. If the debt becomes more than 180 days past due, DoD must transfer the debt to the Treasury, which can use much more aggressive tactics, including withholding a patient's wages or tax refunds, or up to 15 percent of their Social Security benefits. The garnishment of these payments makes a material difference for low-income patients struggling to make ends meet.

"No American should struggle to access health care or be forced to take on debt in order to get the care or coverage they need," Senator Warren wrote. "It is essential that the federal government promote policies to ensure that our nation's healthcare system provides high-quality, affordable health care that does not lead to debt or even bankruptcy or force families to choose between medical care and other necessities."

Senator Warren has requested that Treasury provide answers to her questions and DoD provide a briefing no later than February 11, 2020.