District 9 Councilmember Announces Medical Debt Relief Program

Published on April 16, 2025

District 9 Councilmember Announces Medical Debt Relief Program for San Antonians

SAN ANTONIO (April 16, 2025) — Today, District 9 Councilmember John Courage announced a groundbreaking partnership between the City of San Antonio and Undue Medical Debt, a national 501(c)(3) nonprofit dedicated to erasing burdensome medical debt for those who need it most. Through this initiative, around 45,000 debtors in San Antonio will see some or all of their medical debt disappear – to the tune of roughly $60 million.

Medical debt is a growing concern nationwide—and right here at home. Texas leads the nation in medical debt among the 20 largest counties in the U.S.—and Bexar County ranks third highest, with 20.9% of residents carrying medical debt.* The effects are far-reaching, impacting financial health, mental well-being, housing stability, and access to future care.

“San Antonio has one of the highest rates of uninsured and underinsured residents in the Country. The state’s refusal to expand Medicaid only exacerbates the problem,” the Councilmember said. “This program is about giving people relief—and restoring dignity.”

Backed by the City Council’s approval of the 2025 Budget, Councilmember Courage has allocated $115,000 from the District 9 discretionary fund to support the effort. Because Undue Medical Debt can purchase bundled medical debt portfolios on the secondary market and directly from providers like hospitals at deeply reduced rates, every dollar contributed has the power to relieve a significant amount of medical debt. With this announcement, this investment is relieving $60 million in medical bills at face value.

This is the first time Undue Medical Debt has partnered with a government agency in Texas.

Undue Medical Debt sources qualifying medical debt from local providers and the secondary market, leveraging the City’s funding as it acquires medical debt belonging to current city residents. The criteria for relief are income-based, for those four times (400%) or below the federal poverty level or for whom medical debt is 5% or more of annual income. Finally, there’s no application process (relief cannot be requested). Relief is source-based, meaning this partnership can only relieve qualifying debts acquired from partners who own the debt, like hospitals and collection agencies. In this case, these medical debts have been acquired from a variety of partners. Letters informing patients of relief will arrive in Undue Medical Debt branded envelopes in the coming weeks.

“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,” the Councilmember added. “We can’t fix the whole system overnight—but we can bring immediate relief to thousands of San Antonians.”