I remember telling my mother back in 2009 that I was moving to North Carolina to take a new job. 

“Seems like a nice place,” she said. 

After 14 years here, I’ve concluded it is a nice place. Beaches. Barbeque. Basketball. Consider my heels firmly covered in tar. 

But there’s another thing our great state has become known for: an astonishing amount of medical debt. My research team at HelpAdvisor.com recently published our findings that revealed North Carolina has some of the highest rates of medical debt in the country. In fact, more than one of five North Carolinians with a credit report are carrying around the burden of medical debt.  

Lenoir and Greene counties lead the nation. Nearly 44% of residents there who have credit reports have medical debt in collections. 

North Carolina is home to three of the top four counties in the US with medical debt. And four of the top seven. Seven of the top 14. Nine of the top 18. And 13 of the top 50. 

Medical debt drains savings and retirement accounts, gets in the way of purchasing basic needs, and keeps people pressed into poverty. Perhaps the only thing worse than the debt itself is the predatory practices used to recoup it. Wages have been garnished and liens have been placed on homes. Between 2017 and 2022, North Carolina hospitals filed 5,922 lawsuits to recoup medical debt. 

My mom’s words remind me of another quote. That one is “Esse quam videri,” which is Latin for “To be rather than to seem.” That happens to be our state motto and appears on the official North Carolina state seal. 

And while North Carolina excels at the “seeming,” we can do better at the “being.” 

Just one example of this is Senate Bill 321, better known as the Medical Debt De-Weaponization Act. The original version of the bill (House Bill 1039) was introduced by Republican State Rep. Ed Goodwin, whose 1st District includes three of the top five counties in North Carolina for medical debt.

The bill has received strong bipartisan support from day one and aims to curb medical debt through a host of provisions. Among those include capping interest rates on medical debt at 5%, requiring hospitals to offer payment plans spanning at least two years with installments that do not exceed 5% of monthly income, requiring hospitals to provide free care to patients whose income is at least 200% below the poverty line, and capping the annual out-of-pocket medical expenses for most patients at $2,300. 

North Carolina ranks just 28th in the nation in consumer protection against medical debt. Meanwhile, the genesis of Senate Bill 321 has already been rolled out in at least a dozen other states over the past couple of years alone. 

So what’s the current status of the Medical Debt De-Weaponization Act? Well, it was introduced in May of 2022, died, and then was reintroduced in March of 2023 with no action taken on it since May. 

In other words, the bill is doing a whole lot of seeming and not a lot of being. 

But just as we shouldn’t rely on our state government to save us, we shouldn’t place all the blame on it, either. North Carolina ranks as just the 37th healthiest state in the nation. We’re worse than the national average for rates of obesity, adult diabetes, and smoking. We eat fast food more. We exercise less. Inaction by our lawmakers doesn’t excuse inactivity on our own behalf. 

And when Forbes conducted a study on personal financial responsibility earlier this year, North Carolina was found to rank just 37th in the U.S. 

We can’t afford to sit back and wait for the 170 North Carolinians in the state legislative building to do better for us. The nearly 11 million North Carolinians from across the state need to do better for ourselves. Senate Bill 321 can go a long way toward reducing medical debt for the great people of North Carolina. But the great people of North Carolina can do so much more. 

As our state seal reminds us, let’s “be” rather than to “seem.”