875,000 Veterans, $382 Million in Medical Debt

After he opened the letter and saw the whopping number, McFeely thought he couldn’t be the only one to receive such a notice, and came to learn he wasn’t the only veteran who has faced this type of issue.

“Nearly 40,000 low-income veterans and their survivors receiving federal pensions may owe money because of accounting errors made over the last 12 years,” according to a November 2023 Federal Times article.

McFeely is a Vietnam-era Marine veteran living on a fixed income in a trailer park community in Sarasota County, Fla. He says he retired there after working at Coca-Cola and repairing jukeboxes and pinball machines in Chicagoland for most of his life.

He is patriotic. An American flag and a Marine flag fly on a short pole in his front yard, he has a small shrine to Marines in his living room, and he regularly wears a camouflage hat with ​“MARINE” emblazoned in red. These are daily reminders of his time in the service, for which he says he was stationed at Quantico, Va., from 1969 to 1971, teaching officers to fire the large and mighty howitzer artillery weapon. He said that’s when he suffered a pinched sciatic nerve, which later resulted in two hip replacement surgeries.

After McFeely received the $108,094 notice, he approached news channel 10 Tampa Bay for help — and amplification. After the story aired in November 2023, he said it wasn’t long before his debt was erased.

“I’m not sure the debt would have been canceled if it wasn’t for the news channel,” McFeely said. His story aired about the same time Mil​i​tary​.com published an article reporting that the VA had ​“suspended debt collections related to overpayments of pensions to low-income veterans or their survivors after the agency found it had mistakenly paid too much, in some cases, over a period of many years.”

In a statement provided to In These Times in response to questions about veterans in such situations, a spokesperson for the VA wrote that:

Between 2011 and 2022, there was a data integrity issue in data matching between VA and the Social Security Administration (SSA) and VA was unable to reliably verify the Social Security income of veterans and survivors receiving pensions.

As of January 11, 2024, there were 12,228 living beneficiaries who had a debt established because of the June 24, 2022, SSA Income Match results. VA has canceled the debts related to this data integrity issue for these 12,000 affected beneficiaries. …

There are also approximately 23,000 additional veterans and survivors who may have pension debts that had not yet been established related to the June 2022 SSA data integrity issue. VA resumed processing the claims for these individuals in April 2024 and … no debt will be collected if it resulted from the data integrity issue.

We apologize to affected veterans and their survivors for any distress that these pension debt notifications may have caused.

The overpayments highlighted, among other things, complications veterans can face and the difficulties some have affording proper care for their overall health and well-being. 

In 2022, the Consumer Financial Protection Bureau (CFPB) published some alarming findings in its ​“Medical Debt Burden in the United States” report, including that U.S. medical debt runs upward of $88 billion and is ​“the most common debt collection tradeline on credit records.” 

Medical debt hits low-income individuals and people of color the hardest, and studies show it heavily impacts southern states.

The CFPB noted in that report that ​“four in 10 individuals with household incomes under $50,000 said they had difficulty paying medical bills in the past year compared with 14% of those with household incomes over $100,000.”

The CFPB also noted the VA reported “$382 million in outstanding medical care debt,” and that debt collection activities (paused during the pandemic but restarted in the fall of 2021) would impact ​“approximately 875,000 veterans with pre-pandemic debt.”

In response to questions from In These Times about veteran debt and medical debt, the VA said that in the 2023 fiscal year, out of 9 million veterans who use VA healthcare, ​“there were 2.09 million veterans required to make a copayment to VA for non-service connected care and services provided by VA or VA-authorized referrals to community providers.”

One of the most famous examples of the frustration and despair stemming from veteran debt and the costs associated with health and well-being is from 2019, when John Weigel, a Navy veteran (of the Persian Gulf War) with Huntington’s disease, stood up in front of a packed house for Sen. Bernie Sanders (I-Vt.) to announce he was going to kill himself because he owed $139,000 in medical debt with no way of paying it off.

And there’s no shortage of heart-wrenching stories. A quick online search easily turns up others, like that of Brieux Dash, a 33-year-old father who killed himself at a VA medical center in Florida in 2019.

According to a Washington Post article from July 2023, Dash wrestled with mental health issues after he left the Army and ​“was struggling financially,” according to a lawsuit filed against the VA by his family. The Post reported: ​“In early March, he received a VA notice informing him that he had been overpaid nearly $20,000 in separation pay, the lawsuit stated. Until he repaid that amount, the notice said, his monthly disability compensation would be withheld.” The lawsuit alleged that the notice sent Dash ​“into a downward spiral of depression, anxiety, emotional distress, and fragility.”

I’ve written about veterans’ issues for more than 15 years, but (like most Americans) I’ve only recently begun to understand the severity of the debt crisis. In researching, interviewing and reporting this article, I also found how often medical debt — veteran or not — is interconnected with the exploitative systems that cause it.

With more than 100 million American adults facing medical debt — roughly four in 10 have outstanding bills totaling more than $195 billion — it reinforced my conviction that the only answer to end medical debt is free, universal healthcare.

For veterans, a pat on the back at a baseball game, an up-close parking spot and a 10% discount at select stores is no substitute for a guaranteed living wage and healthcare. Pretending that we are taking care of vets with trivialities instead of basic necessities exposes why capitalism is a losing system for the vast majority of us. Only a government program guaranteeing free healthcare to veterans and everyone else can adequately erase and prevent the medical debt burden carried by far too many Americans.

Medical debt and healthcare issues are also of critical importance for active-duty soldiers. According to another 2022 CFPB report put out by the CFPB’s Office of Servicemember Affairs, more than 5,000 service members and their families reported medical billing complaints to the bureau from 2018 to 2021. The vast majority of these bills happen when active-duty military are sent to private medical centers outside of the Military Health System.

One Mil​i​tary​.com article highlighted Army Spc. Daysha Cartagena and her husband, Staff Sgt. Isaiah Cortez, after bills totalling more than $630,000 landed in their mailbox. Their daughter was moved from Womack Army Medical Center in Fort Liberty, N.C., to a private care center in Raleigh after she turned blue in the delivery room.

Mil​i​tary​.com reported the bills to save baby Mya, who is now a healthy toddler, included $12,166.40 for an air ambulance, $61,634.80 from another private hospital, and $594,564.88 from Duke Health.

Requests for comment from the Department of Defense— which handles these issues for active-duty soldiers — were not immediately returned.

In These Times reached out to the VA to get a better understanding of how the agency handles benefits and claims, among other things. What emerged was a picture of an agency that is dealing with a massive number of requests, which would make sense given that there are more than 16 million veterans in the United States.

Over the years, the VA has been a fairly regular target of criticism for how claims and benefits are sometimes handled. An investigative report from KARE 11 in Minneapolis in 2019, for example, described employees who felt ​“accountable for speed” and sometimes made the determination that it was more efficient to deny claims than to put in the work following them through to payment. In a written response to questions from In These Times, the VA noted that from October 2021 to June 2024, 15,414 claims processors had been brought in, increasing the workers who handle claims by more than 60%. The VA also noted that it had completed more than 1 million claims associated with the PACT Act, which was passed in 2022 and expands benefits to veterans who were exposed to various types of toxic substances. This level of claim completion, the VA said, shows ​“VA’s dedication to its mission to serve veterans.”

In response to a question surrounding how or why benefits for veterans might change, the VA wrote that they attempt ​“to avoid reductions in benefits in most circumstances. However, certain conditions require mandatory reductions based on the VA Schedule for Rating Disabilities. For example, a 100% evaluation for active cancer can be reduced once remission is achieved. If a veteran’s condition shows sustained improvement, VA may only consider reducing the evaluation if, based on the evidence in the claims file, there is actual improvement shown in the ability to function under the ordinary conditions of life and work.”

“An evaluation may not be reduced if it has been in effect for 20 years or more and may not be severed if in effect for 10 years or more,” the statement continued, noting that if a veteran is classified as 100% then that situation is permanent.

But the reality for many veterans is that their benefits only go so far, which means for many of their medical needs, there are associated fees. And as a large number of veterans are low-wealth, these costs can be burdensome.

This article is appearing in a special takeover issue of In These Times in collaboration with Debt Collective, the nation’s first debtors’ union. The Debt Collective organizes debtors to demand abolition of debts stemming from healthcare, education, housing and other basic needs, and to build the struggle across these areas to win a system of genuine public goods.

Over time, Debt Collective has explored various legal and regulatory authorities that grant U.S. government agencies and officials the ability to cancel — or at least mitigate — these different types of debt.

Debt that’s held by federal administrative agencies, like the Department of Education or the VA, can offer unique opportunities for demanding cancellation because these agencies are granted debt settlement authorities by law. The specific authorities or forms this cancellation might take can vary from agency to agency, but Debt Collective’s experience has been that there’s generally more room for them to be employed than what administrators appear to be taking advantage of. Public pressure can do a lot to shift political will and force this type of action — just look at the Biden administration’s student debt relief initiatives, difficult to imagine only a few years ago. There are reasons to imagine a push for the VA to use the full scope of its authority to categorically cancel at least some of the debts it holds over veterans could yield similar relief.

One of the main incentives the military uses to entice young people to sign up is the promise of free college, housing and healthcare. The military, in its search to fill jobs in 800 bases around the world, recruits heavily from working-class Black and brown communities. Then the same government turns its back on so many of these soldiers by issuing bills that often can never be fully paid.

Just like 9/11 first responders — who fought Congress for years to have their medical debt paid after risking their lives— veterans who are so often cast as heroes when needed by politicians are instead cast aside for asking for medical care.

Kristie Fields, a 48-year-old Navy veteran who was medically discharged nearly 30 years ago, said she developed two types of cancer connected directly to her time in the service.

“I slept next door to the engine room on the tugboat I was stationed on between the years of 1994 and 1997,” Fields told me, noting she is now in remission from breast and colon cancer. ​“The fumes were horrible. I woke up each day in that confined space of the hull and then cleaned the boat with harsh chemicals.”

Fields said the bills for treatment got so bad she had ​“no money to pay rent” and needed to lean on family to help pay.

NPR published a piece on veterans and medical debt that featured Fields in June 2023. Immediately after the piece aired, Fields said she received a call from the VA.

“They said I should submit my claim under the PACT Act, and guess what,” Fields said. ​“It was denied again.” The VA said they were unable to respond to questions about Fields and McFeely without signed releases, which they were unable to provide.

When I talked to McFeely about his bill, he made sure to tell me about the suicide hotline number the VA included in the notice.

When the denial of claims and debt is laid at the feet of those with a strong sense of duty and honor, a deep level of psychological drain and depression can set in. Vets can internalize these burdens — many vets like to project an image of strength and mental toughness, and the military teaches soldiers to suppress feelings of weakness — which is likely one of the reasons the suicide rate among vets is somewhere around 60% higher than in nonveterans. Some vets would rather die than appear vulnerable.

At the end of the day, it’s this culture of silence that allows the military to continue its abuse and neglect of former soldiers.

Overall, debt can have a devastating impact on military members, particularly those on a fixed income or with medical conditions, like post-traumatic stress disorder. Vets often first sign up because they believe they owe their country, and the sense of debt and obligation — to themselves, family and country — is visceral. Military service is also an intense source of pride for many, something that helps veterans through days of alienating, low-income jobs that have few avenues for mobility.

We know that debt can kill. Heart attack rates increase when a person is saddled with bills, and those rates increase for Black and brown people. The government harms the people who served by sending these debt notices.

McFeely knows how much debt can weigh on people, especially those who are already struggling. ​“I guess,” he told me, ​“that’s why they include the veteran suicide hotline.”