Medical Bills And Debtors’ Prison

An Indiana cancer survivor. A Nebraska single mom and waitress. An unemployed Utah man. What do these people have in common? They were all jailed, with one committing suicide while incarcerated, because they couldn’t pay their medical bills.

With more than 28 million people in the United States uninsured, and an estimated 41 million under-insured., an unexpected medical emergency or sickness could be financially catastrophic.

In the United States, debtors’ prisons were banned under federal law in 1833. A century and a half later, in 1983, the Supreme Court ruled that incarcerating indigent debtors was unconstitutional.

But according to a recent report by the ACLU, collection agencies have found a new way to jail people for their debt. It is estimated that 77 million Americans — one in three adults — have a debt that has been turned over to a private collection agency.

More than a thousand warrants each year are issued to order the arrest and immediate incarceration of people who owe court fines and fees unless they pay the full amount of their debts before being booked in jail. In a review of court records, the ACLU examined more than 1,000 cases in which civil court judges issued arrest warrants for debtors. Those cases took place in 26 states, including California. The debts owed can be as small as a few dollars and can involve every kind of consumer debt, from car payments to utility bills to student loans to medical bills.

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Here are three of the medical bill stories:

Denise Zencka, a cancer survivor and mother of three, was arrested in Indiana 
in January 2013 for outstanding medical bills for her cancer treatment. Diagnosed with thyroid cancer and unable to work for four months due to the cancer treatment, she was staying with her parents in Florida as she was recovering from the treatment. While she was out of state during that period, she was unaware of and unable to attend small-claims court hearings in Lake County, Indiana, to recover medical bills for her cancer treatment that she was unable to repay.

Three arrest warrants for civil contempt were issued against her for failure to appear. Even though Zencka had filed for bankruptcy, officers of the Lake County Sheriff’s Department came to her home in Crown Point, Indiana, to arrest her. Still dressed in her pajamas, she was arrested in front of her eight-year- old autistic son, four-year-old son, and 12-year-old daughter. She was incarcerated overnight. She was initially held in a large holding cell with several men before she was told to climb stairs to a holding cell for women. She says her blood pressure rose to a high level, which concerned her given her history of seizures and strokes.

Because Zencka was unable to climb the stairs to the women’s section, she was held in a men’s mental health unit of the jail with glass walls that allowed the male prisoners to see everything she did, including use the toilet. She says she was verbally abused, denied medicine, denied feminine hygiene products, and exposed to lewd and “trauma-inducing” behavior, including one man who wiped his feces on the wall of their shared cell.

Rex Iverson got a knock on his door early one Saturday morning in January 2016. A deputy 
sheriff was there to serve Iverson with a $350 bench warrant issued by a Utah justice court shortly after Christmas. Iverson was arrested and jailed at Box Elder County Jail. Jail officials asked Iverson whether he had the money to post bail; because he did not, they took him to a holding cell to wait while the booking process was completed. Later that afternoon, Iverson was found unresponsive, alone in the holding cell.

He was declared dead shortly afterward. A police investigation later determined that Iverson, who was 45 years old, had killed himself with strychnine poison rather than stay in jail.

Iverson had committed no crime. He was incarcerated for failing to appear in court over an unpaid bill for a ride to the hospital on Christmas Eve two years earlier that cost him more than $2,000.23.

Iverson had no means to pay the medical debt, even after he was sued in small-claims court and had a default judgment entered against him. The creditor’s attempt to garnish his wages failed because he was unemployed. He did not show up after the court issued a notice to appear at a hearing regarding the unpaid debt, and a Tremonton Justice Court judge issued a bench warrant for his arrest. Iverson had struggled financially since the death of both his parents in a car crash, and though he had previously worked as a welder and a heavy equipment operator, he was out of work and living in his parents’ home at the time of his arrest. The court did not appoint an attorney to represent Iverson.

In Nebraska, Ms. R, a single mother who works as a waitress, was arrested in her home in front of her children one evening for failure to appear in court over a $176.50 medical debt. When she asked law enforcement officers at the time of her arrest and when she was booked at the county jail what she was being arrested for, they told her they didn’t know. She had been summoned to court for a “debtor’s exam” to answer questions about her income and assets, but she had not received notice of the hearing (called an “Order in Aid of Execution”).

In Nebraska, debtors often are not aware that they have been ordered to appear in court, as the law does not require personal service or proof of actual notice of the order to attend the debtor’s exam; rather it requires only an attempt to serve the order at the person’s last known residence or place of employment.

In Ms. R’s case, the order to appear in court was left with a colleague at the restaurant where she worked and it was never given to her, and there was no proof of service in the court file. An arrest warrant was issued against her for contempt of court for failure to appear. She was searched, forced to change out of her clothing and into a jail uniform, and placed in a locked jail cell with plywood covering the window. Because she did not have the money to pay bail, she was jailed for two hours until her father could arrive with the $100 to bail her out.

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