Subduing an Oppressive Burden

Rev. Donald L. Perryman, D.Min.

By Rev. Donald L. Perryman, Ph.D.
The Truth Contributor

   The burden of poverty isn’t that you don’t always have the things you need, it’s the feeling of being embarrassed every day of your life, and you’d do anything to lift that burden.                                                                                                                   Jay-Z

Collection agencies hold $140 billion in unpaid medical bills, according to recent research by the Journal of the American Medical Association. The massive debt is punishing the bottom line of medical providers, who are stepping up efforts to collect the indebtedness through draconian legal action or wage garnishments.

Medical debt is an oppressive burden for those who incur it not because of frivolous spending decisions but because of necessary health-related emergencies such as heart attacks, illness or surgery.

Medical obligations are also larger and more tyrannical in Black and Hispanic households. Once medical providers report the debt to a credit reporting agency, it is factored into an individual’s credit score. Without relief, medical debt can hurl those without the means to pay or living paycheck to paycheck into financial ruin. Bankruptcy can often be their only option to address outstanding medical debt.

State Representative Michele Grim proposed a medical debt relief model shortly before leaving her first term on Toledo City Council early to run for the Ohio Legislature. In November, Toledo City Council and the Lucas County commissioners approved $1.6 million in American Rescue Plan Act funds to help relieve the crippling burden of paying the medical debt for people living in Lucas County.

I spoke with Grim about her initiative and transition from Toledo City Council to the Ohio House of Representatives.

State Rep. Michele Grim

Perryman: Congratulations on your election to the Ohio Legislature to represent House District 43. Let’s first talk about the medical debt relief initiative you successfully sponsored while on Toledo City Council.

Grim:  Yes, absolutely. So back in November, Toledo City Council passed $800,000 with a match with the Lucas County Commissioners for a total of $1.6 million. That will eliminate between $190-$240 million in medical debt.

We’re partnering with the nonprofit charity RIP Medical Debt, which purchases medical debt from hospital systems, physician groups and other healthcare providers. They also go to the secondary market and buy debt for pennies on the dollar. Our medical relief plan will cancel debt for people up to 400 percent of the poverty level or with medical debt greater than five percent of their income.

Also, the program is based on which hospitals participate. RIP Medical Debt is currently in conversations with a couple of the hospitals in the area. So, that’s how it works.

Perryman: How many people in Lucas County should that help?

Grim:  We estimate about 41,000 people.

Perryman: Can you provide the demographics of those being helped?

Grim:  We estimate that most people with medical debt in the area are people of color or low income. It is something like 50 percent.

Perryman: Where did the medical debt relief program originate?

Grim:  Cook County, Illinois, was the first municipality to use American Rescue Plan dollars to partner with RIP Medical Debt to provide medical debt relief. So, that’s how I got the idea.

I reached out to Cook County, which put me in contact with RIP Medical Debt. We started working on a plan to introduce it in Toledo. I connected them with a couple of the hospitals here, and we devised a plan. Cook County passed its initiative in July 2022, and we passed ours in November.

Perryman: What are the benefits of your medical debt relief initiative?

Grim: Our healthcare system needs to be fixed. This initiative is something very simple that local communities can do to help aid in the economic recovery of our citizens. Lucas County residents, Toledoans are dealing with COVID. They are dealing with inflation, and I can’t think of a better use of our American Rescue Plan dollars than to relieve medical debt.

Medical debt exacerbates several social determinants of health. It exacerbates addictions, prevents people from putting food on the table, prevents them from paying their rent on time and their mortgage or utilities, and hinders people from getting employment. Medical debt is devastating to many people. This initiative is a simple intervention to help aid our local citizens’ economic recovery.

Perryman: Local implementation seems the best option since medical debt relief is difficult to do nationally or through the state.

Grim:  We can look into that statewide as well, and I’m hoping to potentially look into it in my new role as a state representative. The ARPA dollars have been helpful locally. Since we passed our plan here in Toledo, I’ve talked to at least half a dozen other municipalities around the country who want to replicate the Toledo model. New Orleans and Pittsburgh are both moving forward. The City of Columbus introduced it last year.

Perryman: The City of Toledo has already allocated all of its ARPA dollars. Are there other more critical needs or priorities that will get bumped?

Grim:  Nothing is getting bumped. The initiative is less than one half of one percent of the ARPA funds. The debt relief package was actually from the Municipal Revenue Recovery Replacement allocation, a flexible pot of money. I had the administration’s blessing to pull it out of that bucket because it was a huge $72 million pot of money for a flexible spending area. But again, we have a one to 100 return on investment for medical debt relief. Nothing is getting cut or left behind. All of our ARPA projects are moving forward. This is just an additional project that will affect at least 41,000 people in Toledo and Lucas County. Our $1.6 million will eliminate up to $240 million in medical debt.

Perryman: Many readers may question why you ran for the Ohio Legislature after accomplishing so much but serving only one year on Toledo City Council. Could not you have done more for Toledo had you finished your term on city council? I know you will be representing the people of the 43rd District, but what about the rest of the City of Toledo, particularly those affected by food deserts?

Grim: I represent a good portion of Toledo, and that’s what I was elected to do in the State House. I intend to still be very active in the community, working toward healthy food and other healthcare access issues, expanding Medicaid, and expanding our funding for our student-run free clinics and federally qualified health centers. Although my term was short on city council, there’s still so much that I want to do for the local community, and that’s what I intend to do.

Perryman: Let’s stay on the topic of the Ohio Legislature. Talk about the Speaker of the Ohio House of Representatives drama going on that you just walked into. How did that happen? Why did it happen?

Grim: We took a vote as a caucus to vote for the current Speaker. The Republicans were in a position where they needed Democrats. So, we voted, hoping the new Speaker will work with Democrats to get fair maps, public school funding, and ensure we have abortion access here. I know that we’re still dealing with conservative Republicans. I’m hoping that, again, the new Speaker will ensure that the Democrats have a seat at the table, and we can all work together.

Perryman: Are you hoping for favorable committee assignments or to affect state spending to obtain Democratic Party priorities?

Grim: I’m hoping for health committees because that’s my background. But, again, I’m looking forward to working with my fellow legislators. I’d love to work on expanding Medicaid, increasing funding for federally qualified health centers, free student-run clinics and mental health.

Perryman: All 32 Democratic votes went for Jason Stephens. What’s the difference between Stephens and Derek Merrin, who was all set to be Speaker before the House flipped the script? Why did you vote for Stephens and not Merrin, who also represents Toledo?

Grim: Stephens seemed more likely to work with Democrats. We delivered the vote for him, so he seemed more willing to work with us. He’s against the backpack bill because he has no private schools in his district. Public schools would really hurt in his district and ours if they passed the backpack bill. So, that was something that I took into consideration. I think he seems very reasonable.

Perryman: Finally, what advantage do you provide in the State Legislature rather than on city council? And what does your election mean for the people of the Ohio 43rd District?

Grim: I joined the race because we needed strong, effective representation in Columbus. I still believe that, and I thought I was the best person for that. And as I said before, I intend to stay active locally.

We recently lost one local Democrat in the legislature. So, my voice in Columbus is one with experience in government and working with different personalities and other legislators to get things done. That’s what I think I bring.

I’m excited to be working for the constituents of House District 43, bringing resources to the area, and ensuring that we’re thriving here in Toledo and Lucas County. I think it’s essential to have that strong representation down in Columbus, and I’m looking forward to working for the constituents and working for the people.


Contact Rev. Donald Perryman, PhD, at