Medical Debt Volunteer Attorneys

Volunteer Panel

Attorneys wishing to join the Volunteer Panel are embarking on a noble mission to help the thousands of Wisconsin residents living with medical debt. To thank you for agreeing to take at least one client referral, ABC for Health and partner agencies will provide backup support, research and client coordination. You will also be eligible to participate in continuing lawyer education activities free of charge! Some volunteer attorneys are already members of our panel after successful completion of the medical debt training curriculum, held in December 2007. Commitment to represent a client includes anything from brief service and referral to full representation, based on the facts of the particular client referral.

The Process:

Community agencies will refer clients directly to the ABC for Health project coordinator after conducting their own agency intake. ABC for Health in its project intake and coordination capacity will assign clients requesting services to attorneys on the volunteer panel. The coordinator will also serve as the contact person for pro bono attorneys as they progress through their pro bono assignment.

To get started:

1. Register as a Volunteer Attorney

a. Attorneys interested in serving on the volunteer panel can register HERE (online Volunteer Attorney Registration Sheet on the ABC for Health Website).
b. If an attorney attended the December 2007 Medical Debt conference an indicated he/she wanted to serve on the panel, that attorney will be automatically registered.
c. Attorneys registering for and completing the upcoming web cast training will be automatically registered for the volunteer panel
d. ABC for Health will maintain the volunteer panel listing and keep the contact information current

2. Client information

a. Individuals contacting ABC for Health or other legal service agencies will be screened to determine if their case is appropriate for the volunteer panel.
b. If appropriate, agencies are to contact ABC for Health with the client’s current contact information and a brief summary of the case. This referral to the volunteer panel can be made HERE Medical Debt Client Referral Form
c. ABC’s project coordinator will assign the case to a volunteer panel member. Panel members are aware they are to take at least one case when asked. Client conflicts, attorney preference and difficulty of the case will be assessed.

2. Evaluation/Sustainability

a. ABC’s project coordinator will follow up with the volunteer assigned the case to assess progress, offer assistance/back up support, coordinate future referrals. The project coordinator may also call to collect statistics on the case for grant reporting

The Growing Need:

Paying for health care is becoming increasingly difficult. Fewer workers receive coverage through their employers. The percentage of people (workers and dependents) with employment-based health insurance has dropped from 70% in 1987 to 59.5%.[1] This is the lowest level of employment-based insurance coverage in more than a decade.[2] Many insured employees struggle to afford raising deductibles and premiums.[3] Losing a job, or quitting voluntarily, can mean losing affordable coverage for the worker and often the entire family. Only 7% of the unemployed can afford to pay for COBRA health insurance.[4] When there is a health crisis in a family, the uninsured are being forced into emergency rooms or are increasingly paying "up front" for medical treatment, paying large sums before services will be rendered. When they are unable to pay the full medical bill in cash at the time of service, it is conceivable they can be turned away,[5] compromising the health of the uninsured.[6] The inability to pay coupled with treatment means compounding medical bills and eventual debt burden for the entire family.

Nearly 47 million Americans, or 16% of the population, were without health insurance in 2005, the latest government data available.[7] Nearly 21 million of the nation's 79 million children have at least one disabling condition.[8] The medical care that these children require can often lead to expenses far out of proportion with their numbers. These families are most at risk of accumulating large medical debts. But even those with health insurance are not as financially insulated from risk of debt and bankruptcy as they may believe. Medical care must be obtained quickly and involuntarily and medical expenses can greatly exceed the limits of what private insurers pay for services. Any consumer can be financially devastated by an unforeseen medical expense. Medical debt was cited as a reason for half of all personal bankruptcy filings in the United States.

A recent State Bar of Wisconsin comprehensive study examined unmet legal needs in Wisconsin. More than 500,000 state residents face serious civil legal problems without any legal assistance, according to the findings of a State Bar of Wisconsin study, “Bridging the Justice Gap: Wisconsin’s Unmet Legal Needs,” issued in March 2007.[9],[10] The report found that the legal problem most frequently facing the poor, particularly people with disabilities, is the loss or reduction of public benefits. Nearly 70% of the sample received some form of public assistance,[11] including 42% of respondents where at least one person in their household received Medicaid.[12] Nearly 20% of respondents experienced a problem getting or keeping benefits, particularly food stamps, Medicaid, Social Security, or Supplemental Security Income.[13] As a result of this problem, medical debt and the collection of that debt became a devastating issue. The shocking statistics show that 15% of people responding to the survey said that they had been contacted by a collection agency regarding unpaid medical bills.[14] This statistic is supported by national data as well. Over a third of the uninsured have problems paying medical bills.[15] The unpaid bills were substantial enough that many had been turned over to collection agencies.[16]

Rising levels of medical debt and bankruptcy are affecting people across Wisconsin. People need basic information about preventing medical debt, as well as options for paying for their medical debt. Public interest attorneys encounter many cases of families with serious medical debt, yet still many more clients never learn about our services, or more importantly, the strategies available to minimize medical debt. The passage of BadgerCare Plus in early 2008 may alleviate some of the children living without health care coverage. Even now, however, half of the uninsured children in Wisconsin are eligible for state health programs but not enrolled.[17] The implementation and execution of BadgerCare Plus are going to be critical. For one, it’s a very complicated program. More will need to be done to ensure that children can get enrolled and remain enrolled in the programs.

Footnotes:

[1] The Henry J. Kaiser Family Foundation. Employee Health Benefits: 2006 Annual Survey, 26 (Sept. 2006); Center on Budget and Policy Priorities. The Number of Uninsured Americans is at an All-Time High. 29 (Aug. 2006).

[2] Id.

[3] Even if employees are offered coverage on the job, they can't always afford their portion of the premium. Employee spending for health insurance coverage (employee's share of family coverage) has increased 143 percent between 2000 and 2006. The Henry J. Kaiser Family Foundation. The Uninsured: A Primer, Key Facts About Americans without Health Insurance. January 2006.

[4] M. Dalrymple, "Senators Seek Tax Credit for Unemployed." Associated Press, 9 (Oct. 2003).

[5] Supra, note 3.

[6] Lack of insurance compromises the health of the uninsured because they receive less preventive care, are diagnosed at more advanced disease stages, and once diagnosed, tend to receive less therapeutic care and have higher mortality rates than insured individuals. Institute of Medicine. Care Without Coverage – Too Little, Too Late. The National Academies Press (2002).

[7] DeNavas-Walt, C.B. Proctor, and C.H. Lee. Income, Poverty, and Health Insurance Coverage in the United States: 2005. U.S. Census Bureau., August 2006. Nonetheless, an estimated 71,000 children in Wisconsin were uninsured at a given time in 2006, up from an estimated 63,000 in 2005, according to the state's 2006 Family Health Survey. The study found that an estimated 48,000 children were uninsured for all of last year.

[8] The number of uninsured children in 2005 was 8.3 million, 11.2% of all children in the U.S. The number of children who are uninsured increased by nearly 400,000 in 2005, breaking a trend of steady declines over the last five years. Supra, note 6.

[9] Wisconsin Lawyer, Bridging the Justice Gap: Gauging the Public’s Unmet Civil Legal Needs, vol. 80, no. 4 (April 2007), available at: http://www.wisbar.org/am/template.cfm?section=wisconsin_lawyer&template=/cm/contentdisplay.cfm&contentid=63720

[10] Bridging the Justice Gap: Wisconsin’s Unmet Legal Needs, Final Report, Access to Justice Study Committee
State Bar of Wisconsin (March 2007). This report and its recommendations were adopted by the State Bar Board of Governors on May 8, 2007. People at 125% FPG (154,000 or 11%) and between 125% and 200% FGP (310,000 or 21%) were surveyed.

[11] Bridging the Justice Gap, at 6.

[12] Id.

[13] Id.

[14] Id. at 7.

[15] The Henry J. Kaiser Family Foundation. Access to Care for the Uninsured: An Update. 29 September 2003.

[16] Id.

[17] Guy Boulton, State moves on health insurance for children: BadgerCare Plus to be available to all kids regardless of income, Milwaukee Journal Sentinel, Nov. 7, 2007 available at: http://www.jsonline.com/story/index.aspx?id=683937