Opinion | Michigan has tools to ease medical debt. Does it have the will?

Like many Michiganders, I’ve struggled to make sense of my medical bills. Recently, I found basic math errors on a bill. I felt a familiar dread — not just about the error, but about the exhausting process ahead. I called the billing office at least five times over three weeks, only to be told I couldn’t possibly be right because key information wasn’t even visible on my statement.

This is the predictable result of a system designed for confusion. Left unchallenged, medical billing errors can escalate and affect families for years. Correcting these errors is one of the few ways to stop medical debt before it takes root.

Across Michigan, nearly 1 million adults carry medical debt. That’s more than double the combined populations of Grand Rapids, Lansing and Ann Arbor. A staggering 80% of medical bills contain inaccuracies, yet these mistakes often go unchallenged. When patients don’t understand their bills or feel powerless to question them, they’re more likely to overpay, give up, or allow the bill to go to collections — damaging their credit, disrupting housing or employment prospects and widening gaps in who gets care and who doesn’t.

The frustrating truth is that billing errors are often fixable. About three-quarters of patients who dispute a bill get the mistake corrected, and many who negotiate unaffordable bills succeed in reducing them. But doing so requires time, literacy, confidence and stamina— resources in short supply for many people.

With federal efforts to address medical debt rolling back and economic strain deepening, patients are facing this complexity with less support than ever.

That’s where Community Health Workers (CHWs) can make a difference. These trusted, locally embedded professionals already help Michigan residents manage chronic conditions, navigate insurance, and access health and social services — building trust in systems that often feel inaccessible. The Michigan Community Health Worker Alliance (MiCHWA) provides standardized training and maintains a statewide registry, while the Michigan Department of Health and Human Services (MDHHS) continues to support and expand this workforce.

But there’s a critical gap. Most CHWs are not trained to assist with medical billing or help patients apply for financial assistance programs. With targeted instruction, they could spot billing errors, coach patients through conversations with billing offices and connect families to nonprofit support like Dollar For, which helps people apply for hospital-based aid.

Some may wonder whether billing help fits within a CHW’s responsibilities. But financial strain is a public health issue. Medical debt worsens mental health, drives housing and food insecurity, and leads people to delay or forgo care. 

Michigan doesn’t need to start from scratch. It needs to unlock the full potential of a model that’s working. By investing in specialized education and integrating billing support into CHW programs, the state can lead on one of the most overlooked but solvable threats to public health: financial stress from medical billing.

Medical bills shouldn't drive families into bankruptcy because they couldn’t understand a charge or find help. We have the workforce and tools. Now we need the will to put them to work.