As a nonprofit health attorney over a decade ago I worked in North Carolina on pushing hospital systems to eliminate the practice of suing lower income patients for medical debt and associated abuses like pursuing liens against the houses of poor families. A Pulitzer-prize nominated newspaper series detailed the situation at the time in North Carolina. Advocates came up with multiple suggestions for improving these practices to reform medical debt collection and to help children and families. While some hospitals voluntarily changed their policies and significantly improved their charity care policies at the time, the problem unfortunately persisted over the next ten years.