Patients Rising

Wisconsin presents the most concentrated medical-bankruptcy pattern in our six-state series. Across 104 individual Chapter 7 and Chapter 13 filings from the Eastern and Western Districts of Wisconsin in January and February 2024 — just two months — the data shows the highest 340B exposure rate, the highest medical-debt rate, the densest verified-340B dollar accumulation per unit of time, and the most concentrated single-system dominance of any state we have examined.

Read our report here:

What 104 Wisconsin Bankruptcy Filings Reveal | 340B Hospital Debt Aurora Health Care appears on 48 of 104 Wisconsin bankruptcy filings. A two-month review of $1.16M in 340B hospital debt and what it reveals.

Healthcare debates are often fought at 30,000 feet. Patients live them on the ground.

From the industry's perspective, there are contracts, formularies, utilization management programs and cost controls. From the patient's perspective, there is a prescription that was approved yesterday and denied today. There is a treatment delayed. There is another form to complete while symptoms continue.

The healthcare system is full of competing priorities. Patients only have one.

PCMA is coming to the table. Patients Rising is here to listen, and we're bringing the patient perspective into the room.

Sign up here and be part of the conversation: https://hubs.ly/Q04jrqvz0

PBMs have become one of the most debated parts of the healthcare system.

Supporters point to their role in negotiating costs and managing prescription drug benefits. Patients often point to experiences with prior authorizations, step therapy, formulary changes and coverage decisions that can create barriers to care.

On June 4, Patients Rising and PCMA are coming together for a conversation about where those perspectives meet.

What do PBMs actually do? What changes are being discussed? What concerns are patients raising, and how should the industry respond?

Join Terry Wilcox and senior leaders from PCMA for a live virtual town hall. Half of the program will be devoted to questions from patients, caregivers and advocates.

We'd love to have you join us! Register here: https://hubs.ly/Q04jNv2w0

Most people assume medical bankruptcy happens because someone didn't have insurance.

What if that's not the whole story?

Patients Rising reviewed 146 bankruptcy filings from Washington state and found more than $1 million in verified medical debt owed to hospitals participating in the federal 340B program. The largest share of that debt was concentrated within a single nonprofit hospital system.

In fact, 81% of the bankruptcy cases reviewed included medical debt, and more than one-third included verified debt owed to a 340B-participating hospital.

Read more here:

What 146 Washington Bankruptcy Filings Reveal | 340B Hospital Debt Providence Health appears on 41 of 47 verified 340B creditor lines in our Washington bankruptcy review. 146 filings, $1 million in hospital debt.

"It's a bad day, not a bad life."

It's the mantra that you can see on Kimberly Gonzalez's social media profiles as she passionately tells her story and advocates for the rare disease community.

Living with scleroderma, Raynaud’s, and antiphospholipid syndrome, Kim knows firsthand the challenges patients face navigating complex care. But what stands out even more than her diagnosis is her determination to turn adversity into action.

Patients Rising is proud to have Kim as part of the Patients Rising Patient Senate.

Learn more about our Patient Senators here: https://hubs.ly/Q04jsXrc0

Kathy Missel is raising questions about whether the billions generated through the 340B program are truly reaching the vulnerable patients the program was originally designed to help. In her guest column, she examines how some Illinois hospitals now generate far more in 340B profits than they spend on charity care, while patients continue facing high medical bills and barriers to care.

As lawmakers consider expanding protections for the program, she talks about the growing debate around transparency, accountability and whether the financial benefits of 340B are making a measurable difference for the people it was created to serve.

Read her story here:

Hope Without Accountability Isn't Enough: 340B in Illinois A rural Illinois cancer patient asks why hospitals profit from the 340B program while patients still struggle to access care. HB 2371 deserves scrutiny.

For years, PBMs have operated largely out of view of the patients whose lives their decisions shape. Denials. Prior authorizations. Step therapy. Formulary changes. Lost records. For the sickest patients, the consequences have been serious — and in some cases, devastating.

On June 4, PCMA is sitting down with Patients Rising. About what PBMs actually do. About what's changing. About what accountability needs to look like from here.

Patients have questions. This is where we ask them.

Join host Terry Wilcox for a 60-minute virtual town hall with senior leaders from the Pharmaceutical Care Management Association. Half the hour is audience Q&A.

Sign up here:

PBMs at an Inflection Point: An Opportunity for a Candid Conversation For years the PBM conversation has been dominated by blame. PCMA is coming to the table. Patients Rising is here to listen — and we have a word, too. Join us June 4 at 2 PM ET. Half the hour is Q&A.

Michelle knows what it means to fight for care that should never have been difficult to access in the first place.

After her daughter Leslie was diagnosed with Prader-Willi syndrome nearly 28 years ago, Michelle found herself battling insurance companies for therapies, medications and support services that directly impact quality of life.

Instead of stepping back, she stepped further into advocacy.

Michelle went on to serve as a board member and Board Chair of PWSA/USA, later expanding her work into government-level advocacy because she believes real change happens when lawmakers hear directly from patients and caregivers living these issues every day.

As part of the Patients Rising Patient Senate, Michelle brings a perspective shaped by decades of experience navigating Medicaid, insurance barriers and the long-term realities families face when care systems fail to communicate across state lines. She is passionate about improving Medicaid portability for adults with disabilities, reforming the role of PBMs and ensuring patient voices are part of policy conversations from the beginning, not as an afterthought.

We appreciate your advocacy, Michelle!

A study published from last year from the National Consumers League released results of a poll taken from 20,000 adults with an overwhelming concern about the burden of medical debt and strong public demand for comprehensive reforms of the 340B Drug Pricing program.

Nearly four in five surveyed adults (78%) support establishing requirements to ensure that qualifying patients directly benefit from 340B drug discounts through reduced out-of-pocket prescription drug costs. More than three in four surveyed adults (77%) believe hospitals should be required to pass 340B savings directly onto patients.

A household in Fredericksburg, Virginia, filed for Chapter 7 bankruptcy in February 2024. Their bankruptcy schedule shows $478,313 in total liabilities, of which $379,261 — eighty-one percent — is medical debt. The bulk of that debt, $376,855, is owed to a single Virginia hospital system: Mary Washington Healthcare. Their monthly income, by the schedule, was $5,160. Their monthly expenses, $5,426. Their margin, before any payment toward the bankruptcy debt: negative $266 a month.

Over the course of 2025 and 2026, Patients Rising reviewed approximately 900 individual Chapter 7 and Chapter 13 bankruptcy filings from federal bankruptcy courts in six states: Virginia, Wisconsin, Washington, Louisiana, Colorado, and Maine.

Here's what we found.

Medical Bankruptcy in America: What 900 Filings Across Six States Reveal 900 bankruptcy filings across six states show patients owing 340B-participating hospitals millions. None were told they were 340B patients before filing.