A news story also gained traction on Reddit’s sister site Imgur in a related post contrasting two concurrent Reddit threads:
The post shown here was the same r/news Reddit post linked above, itself pointing to a February 9 2020 CBS News article headlined, “‘You wouldn’t think you’d go to jail over medical bills’: County in rural Kansas is jailing people over unpaid medical debt.” CBS News and investigative nonprofit ProPublica reported on one family in Coffeyville, Kansas and their experience with mounting medical debt and, subsequently, jail time:
Tres Biggs went to jail for failing to appear in court for unpaid medical bills. He described it as “scary.”
“I was scared to death,” Tres Biggs said. “I’m a country kid — I had to strip down, get hosed and put a jumpsuit on.”
Bail was $500. He said they had “maybe $50 to $100” at the time.
In rural Coffeyville, Kansas, where the poverty rate is twice the national average, attorneys like Michael Hassenplug have built successful law practices representing medical providers to collect debt owed by their neighbors … That law was put in place at Hassenplug’s own recommendation to the local judge. The attorney uses that law by asking the court to direct people with unpaid medical bills to appear in court every three months and state they are too poor to pay in what is called a “debtors exam.”
If two hearings are missed, the judge issues an arrest warrant for contempt of court. Bail is set at $500.
Hassenplug said he gets “paid on what’s collected.” If the bail money is applied to the judgment, then he gets a portion of that, he said.
Biggs was jailed after missing an appearance related to unpaid medical debt, thanks to a law put into place on the recommendation of attorney Michael Hassenplug. Hassenplug told CBS he is compensated in part through bail money collected in the course of hearings like the one Biggs reportedly missed.
In the comments on Facebook, some users argued that the reported imprisonment was not directly due to medical debt, but for missed hearings:
The headline is super mis-leading. NO ONE is going to jail for not paying their debt, medical or otherwise. They are going to jail when the Court enters an Order requiring them to show up in court and they don’t show up, in contempt of court.
Biggs was originally the subject of a far larger, far more detailed investigation by ProPublica published in October 2019. That reporting provided extensive detail on medical debt court cases in Coffeyville, Kansas, the role of Hassenplug’s firm in it, and the unorthodox array of conditions enabling its existence in the first place. ProPublica reported that of the missed hearings, some “fell on days when [Biggs’ son] Lane had [leukemia] treatment, at a hospital in Tulsa, an hour south,” and that Biggs’ wife Heather refused to postpone their child’s cancer care:
[A] warrant, [Biggs] learned at the jailhouse, was for failure to appear in court for an unpaid hospital bill. Coffeyville Regional Medical Center had sued him in 2006 for $2,146, after one of Heather’s emergency visits; neither of his jobs offered health insurance. In the shuffle of 70-hour workweeks and Lane’s chemotherapy, he had missed two consecutive court dates. He was fingerprinted, photographed, made to strip and told to brace himself for a tub of delousing liquid. His bail was set at $500 cash; he had about $50 to his name.
His friend bailed him out the next morning, but at the bond hearing, the judge granted the $500, minus court fees, to the hospital. Biggs compensated his friend with a motorboat that a client had given him in exchange for a hunting dog. But it wasn’t long before the family received a new summons. In 2009, a radiologist represented by Hassenplug sued them for $380.
The article included some background and ongoing information about the Biggs’ entire medical and financial picture, and that after his imprisonment, “Biggs was still on the hook for the bill that had landed him in jail; bail had covered only part of it, and the rest was growing with 12% annual interest.” Further, the hospital had garnished Biggs’ wages, and the radiologist had garnished his bank account, seizing contributions that his family had raised for Lane’s cancer treatment:
By 2012, the Biggs family had accrued more than $70,000 in medical debt, which it owed to Coffeyville Regional Medical Center and other hospitals, pediatricians and neurologists. Some forgave it; others set up lenient payment plans. Coffeyville’s was the only hospital that sued. The doctors who took them to court were represented by Hassenplug.
ProPublica’s fourth paragraph began with an introduction to the presiding judge — a man without any legal background:
Judge David Casement entered the courtroom, a black robe swaying over his cowboy boots and silversmithed belt buckle. He is a cattle rancher who was appointed a magistrate judge, though he’d never taken a course in law. Judges don’t need a law degree in Kansas, or many other states, to preside over cases like these.
In 2017, The Atlantic reported that Kansas was one of a handful of states where judges like Casement “don’t need a law degree” in order to put defendants behind bars:
Montana and seven other states — Arizona, Colorado, Nevada, New York, Texas, South Carolina, and Wyoming — allow non-lawyer judges to hand down jail sentences for misdemeanors without the right to a new trial before a lawyer-judge. Some states, like Montana, only allow the practice in rural or sparsely populated counties, while others allow it statewide.
The situation may have been acceptable in the 19th century, when lawyers and law schools were scarce, critics say. But in the modern era, they say it raises serious questions about due process and the Sixth Amendment right to a fair trial. “What’s the point of having a legally-trained lawyer if the judge can’t understand what they’re saying?” said Stuart Banner, a University of California Los Angeles law professor.
Biggs was not the only medical debt sufferer featured in ProPublica’s story. In one excerpt, Hassenplug faced off against a young survivor of a suicide attempt, whose income of disability checks was exempt from the reach of the court and its orders:
SEATED AT THE FRONT of the courtroom, Hassenplug zipped open his leather binder and uncapped his fountain pen. He is stout, with a pinkish nose and a helmet of salt and pepper hair. His opening case this Tuesday involved 28-year-old Kenneth Maggard, who owed more than $2,000, including interest and court fees, for a 40-mile ambulance ride [in 2018]. Maggard had downed most of a bottle of Purple Power Industrial Strength Cleaner, along with some 3M Super Duty Rubbing Compound, “to end it all.” His sister had called 911.
Maggard took his seat. He had cropped red hair, pouchy cheeks and mud-caked sneakers. “The welfare patients are the most demanding, difficult patients on God’s earth,” Hassenplug told me, with Maggard listening, before launching into his interrogation: Are you working? No. Are you on disability? He was diagnosed with schizoaffective disorder, bipolar type, and anxiety. Do you have a car? No. Anyone owe you money you can collect? I wish.
They had been here before, and they both knew Maggard’s disability checks were protected from collections. Hassenplug set down his pen. “Between you and me,” he asked, “you’re never going to pay this bill, are you?”
“No, never,” Maggard said. “If I had the money, I’d pay it.”
Hassenplug replied, “Well, this will end when one of us dies.”
Another man jailed in the course of the court’s operations had no means to travel to the rural courthouse:
Derek Dustman, who is 36 and works odd jobs, had been driving a four-wheeler when he was hit by a car and rushed to the hospital. Though he was sued for not paying his $818 ambulance bill, he didn’t have a license to drive to the courthouse. This spring [in 2019], he spent two nights in jail. “I never in a million years thought that this would end with jail time,” he told me.
Much of the reporting concerned confusing or conflicting information provided by parties involved — such as Casement and Hassenplug — about the legal authority of debt collectors to influence decisions such as the issuance of a bench warrant or the imprisonment of any individual for inability to appear before the court or pay a medical debt. In one excerpt about a woman named Christa Strickland and her attempts to pay a 2008 bill for $2,514 (which had risen to $5,736 thanks in part to court fees by October 2019), ProPublica requested clarification from Account Recovery Specialists Inc. (ARSI) and from a lawyer named Amber Brehm.
Lizzie Presser, who reported on the issue for the ProPublica, explained Strickland’s frantic attempts to avoid a bench warrant after missing a hearing by one day:
When I asked ARSI about how attorneys decide to request warrants, Joshua Shea, who is general counsel, told me that they don’t. The judge can choose to issue one if court orders are not followed, he said. But Casement said the opposite, telling me that he gave the choice to the attorneys. “I’m not ordering a bench warrant. My decision is to give them that option,” Casement told me. “Whether they exercise it is up to them, but they have my blessing if that’s what they want to do.”
Shea sent me an eight-page email to make clear, in large part, that ARSI, as a collection agency, has no involvement in the courts, and that Brehm is a lawyer whom the agency contractually employs and who represents the hospital directly. Her email address, though, has an ARSI domain, and her resume lists her as ARSI’s director of legal. Brehm said that court hearings aren’t the only option for debtors, who can call her instead and answer questions under oath. Shea said nobody — not the hospital, ARSI, Brehm or the court — uses the threat of jail to “extract payment.”
Strickland reached Brehm after several days, and the attorney agreed to a new hearing. On Aug. 13 , when they met in court, Brehm sat at the front of the room.
“We’re giving you a second chance on that citation; just to try to take care of this without there having to be any sort of bench warrant,” [Brehm] said. “I want to make sure that we’re all on the same page about the consequences of not coming into court when the order has been issued.”
“Again, if you set a payment plan and keep it,” Brehm said, “we won’t have to worry about that.”
Other news outlets followed up on the way Coffeyville handles of medical debt in February 2020, independently confirming the ProPublica investigation, which (as we mentioned) was originally published in late 2019. CBS News reported that while their cameras were not permitted, only one of 60 medical debtors present on the day they visited had a lawyer with them:
CBS News went to court on debt collection day. They wouldn’t allow our cameras in, but we watched more than 60 people swear they didn’t have enough money to pay, and only one of them had an attorney representing them.
In related fact checks, the question of whether medical debt was the cause of bankruptcies emerged as a point of dispute in the same way that commenters argued people were jailed not over debt, but over missed court appearances. Semantic objections of that description seemed to be the only counterargument involved, since both instances involved otherwise accurate and verified claims.
In February 2020, CBS News rehashed the findings of a late 2019 ProPublica investigation into people in Kansas jailed over medical debt, largely thanks to an unusual rural court system that was influenced by debt collection firms and lawyers. That investigation and subsequent interviews with lawyers and debt collectors involved confirmed the accuracy of the report — that people in Kansas were indeed jailed due to unpaid medical debt. A presiding judge said that lawyers had broad discretion, and that at least one victim reported missing hearings because they were taking their child to receive cancer treatments. None of the parties involved disputed that people were jailed over medical debt in various independent investigations, and thus we can comfortably rate the claim as True.