CHARLOTTE, N.C. — $220 billion. That's how much Americans owe in medical debt, according to a new report from NBC News.
Medical bills have followed Terry Belk since 2003, when his wife Sandra was diagnosed with breast cancer.
"We had private health insurance, and we thought we had good insurance," he told NBC Senior Business Correspondent Christine Romans from his Charlotte home. "But anyway, that was $23,000."
Belk has been telling his story for years - talking to WCNC Charlotte in 2022.
"It's a lot of money to me," Belk told WCNC Charlotte in 2022.
"I wasn't running away. I was trying to actually... pay them," Belk told Romans.
About 14 million Americans owe at least a thousand dollars in medical debt, according to the Kaiser Family Foundation. The top three states are South Dakota, Mississippi and Belk's home state of North Carolina.
As his wife battled cancer, Belk stopped working as a car salesman to care for her. Then the calls started to come.
"They was threatening lawsuits and judgments and ruining our credit," he said.
Belk signed a deed of trust with the health system. This allowed them to be paid $23,000 when he sells his home.
"It's like an albatross around my neck," Belk told Romans.
A spokesman for Atrium Health told NBC News they stopped filing liens to collect unpaid debts owed by patients in 2022 and has used litigation against patients as a last resort. Belk signed the deed of trust voluntarily, the spokesman said, and "presumably on the advice of his attorney."
Medical debt is not always thousands of dollars.
"The average medical debt is not necessarily 10s of 1000s of dollars," Berneta Haynes, a senior attorney at the National Consumer Law Center, explained. "It can literally just be $1,000, that for that a person owes, that they simply can't pay.
Medical debt is the biggest cause of personal bankruptcy. Tactics to collect the debt, can range from garnishing wages, putting a lien on someone's house or even a civil arrest warrant.
In June, Vice President Kamala Harris and the director of the Consumer Financial Protection Bureau announced a proposal to remove medical debt from people's credit reports. According to the White House, this plan would help lead to the approval of 22,000 more mortgages a year.
"As you know, credit reports are extremely important when folks are trying to obtain a loan for a home or an auto loan," Haynes explained.
As president, Donald Trump cracked down on surprise out-of network bills that can lead to so much medical debt.
Some states are passing their own laws to protect citizens against interest and late fees, liens on their homes, or abusive collection tactics.
North Carolina Governor Roy Cooper negotiated with hospitals to eliminate four billion in debt for medicaid beneficiaries going back to 2014.
But Belk said his debt is too old to qualify for the recent relief. And now there's more. Belk owes $8,000 for his own prostate cancer treatment.
"I'm sure I'm going to take this debt into the afterlife," Beld said.
For Belk and millions of americans, health care has turned into a financial crisis.