Bankruptcy Abuse Prevention And Consumer Protection Act Of 2005
Mr. Speaker, this bill hurts Americans. One group who will be especially hurt are family forced into bankruptcy because of a medical crisis. A recent study conducted by professors at Harvard Medical and Law School showed that about half of…
Mr. Speaker, this bill hurts Americans. One group who will be especially hurt are family forced into bankruptcy because of a medical crisis.
A recent study conducted by professors at Harvard Medical and Law School showed that about half of all personal bankruptcies can be attributed to medical costs.
Among those who cited illnesses as a cause of bankruptcy, the average unreimbursed medical costs totaled nearly $12,000 even though more than three-quarters had health insurance.
How does the bill hurt the families? Under the bill for the first time there will be a presumption that many of these families abuse the bankruptcy system. Under current law, people facing a medical bankruptcy can seek several forms of relief. Chapter 7 is by far the most common. Under 7 debtors are required to forfeit all of their property other than the exempt assets in exchange for having their debts extinguished.
Current law already gives bankruptcy courts discretion to deny chapter 7 relieve where the filing is found to be a substantial abuse. But unlike this bill, current law provides a presumption in favor of granting relief to the debtor.
The other option is chapter 13 where a debtor is required to continue paying creditors. This makes it more difficult for debtors to get back on their feet.
This bill will hurt families facing medical bankruptcy because it will force many of them into chapter 13. That is because it presumes that these families are abusing the bankruptcy system if they fail the means test. The means tests starts with a family's income and then subtracts monthly expenses permitted by IRS guidelines. But instead of using a debtor's actual projected income, the means tests uses the debtor's average income over the prior 6 months. Thus, if a family's bankruptcy was triggered by a loss of income resulting from a serious illness, the means test would still attribute the lost income for the purpose of determining whether the family is abusing the bankruptcy system.
Further, the means test uses the median income for a State. My constituents in Santa Clara County live in a
high-cost area. Almost nobody will be able to discharge their debts in bankruptcy from Santa Clara County because of that high cost, no matter how meritorious for their claim for relief.
Similarly, instead of using the debtor's actual expenses, the inflexible guidelines developed by the IRS is used. As a result, more families facing medical bankruptcy will be presumed to be abusing the system, will be forced into chapter 13 and will never be able to stand on their feet again. That is not right.
The Harvard study found that these struggling families did everything they could to pay their medical bills to avoid bankruptcy. One in five skipped meals. One-third had their electricity cut off. Almost half lost their phone service. One in five was forced to move.
Incredibly, they also cut back on needed medications to try to avoid bankruptcy. In fact, half went without needed prescriptions. And a full 60 percent went without a needed doctor appointment.
Please join me in opposing this unfair bill.
[From Market Watch]
Illness and Injury as Contributors to Bankruptcy
(By David U. Himmelstein, Elizabeth Warren, Deborah Thorne, and Steffie
Woolhandler)
ABSTRACT: In 2001, 1.458 million American families filed
for bankruptcy. To investigate medical contributors to
bankruptcy, we surveyed 1,771 personal bankruptcy filers in
five federal courts and subsequently completed in-depth
interviews with 931 of them. About half cited medical causes,
which indicates that 1.9-2.2 million Americans (filers plus
dependents) experienced medical bankruptcy. Among those whose
illnesses led to bankruptcy, out-of-pocket costs averaged
$11,854 since the start of illness; 75.7 percent had
insurance at the onset of illness. Medical debtors were 42
percent more likely than other debtors to experience lapses
in coverage. Even middle-class insured families often fall
prey to financial catastrophe when sick.
``If the debtor be insolvent to serve creditors, let his
body be cut in pieces on the third market day. It may be cut
into more or fewer pieces with impunity. Or, if his creditors
consent to it, let him be sold to foreigners beyond the
Tiber.''
--Twelve Tables, Table III, 6 (ca. 450 B.C.)
Our bankruptcy system works differently from that of
ancient Rome; creditors carve up the debtor's assets, not the
debtor. Even so, bankruptcy leaves painful problems in its
wake. It remains on credit reports for a decade, making
everything from car insurance to house payments more
expensive. Debtors' names are often published in the
newspaper, and the fact of their bankruptcy may show up
whenever someone tries to find them via the Internet.
Potential employers who run routine credit checks (a common
screening practice) will discover the bankruptcy, which can
lead to embarrassment or, worse, the lost chance for a much-
needed job.
Personal bankruptcy is common. Nearly 1.5 million couples
or individuals filed bankruptcy petitions in 2001, a 360
percent increase since 1980. Fragmentary data from the legal
literature suggest that illness and medical bills contribute
to bankruptcy. Most previous studies of medical bankruptcy,
however, have relied on court records--where medical debts
may be subsumed under credit card or mortgage debt--or on
responses to a single survey question. None has collected
detailed information on medical expenses, diagnoses, access
to care, work loss, or insurance coverage. Research has been
impeded both by the absence of a national repository for
bankruptcy filings and by debtors' reticence to discuss their
bankruptcy, in population-based surveys, only half of those
who have undergone bankruptcy admit to it.
The health policy literature is virtually silent on
bankruptcy, although a few studies have looked at
impoverishment attributable to illness. In his 1972 book,
Sen. Edward Kennedy (D-MA) gave an impressionistic account of
``sickness and bankruptcy.'' The likelihood of incurring high
out-of-pocket costs was incorporated into older estimates of
the number of underinsured Americans: twenty-nine million in
1987. About 16 percent of families now spend more than one-
twentieth of their income on health care. Among terminally
ill patients (most of them insured), 39 percent reported that
health care costs caused moderate or severe financial
problems. Medical debt is common among the poor, even those
with insurance, and interferes with access to care. At least
8 percent, and perhaps as many as 21 percent of American
families are contacted by collection agencies about medical
bills annually.
Our study provides the first extensive data on the medical
concomitants of bankruptcy, based on a survey of debtors in
bankruptcy courts. We address the following questions: (1)
Who files for bankruptcy? (2) How frequently do illness and
medical bills contribute to bankruptcy? (3) When medical
bills contribute, how large are they and for what services?
(4) Does inadequate health insurance play a role in
bankruptcy? (5) Does bankruptcy compromise access to care?
a brief primer on bankruptcy
``Bankrupt'' is not synonymous with ``broke.'' ``Bankrupt''
means filing a petition in a federal court asking for
protection from creditors via the bankruptcy laws. A single
petition may cover an individual or married couple. The
instant a debtor files for bankruptcy, the court assumes
legal control of the debtor's assets and halts all collection
efforts.
Shortly after the filing, a court-appointed trustee
convenes a meeting to inventory the debtor's assets and debts
and to determine which assets are exempt from seizure. States
may regulate these exemptions, which often include work
tools, clothes, Bibles, and some equity in a home.
About 70 percent of all consumer debtors file under Chapter
7 of the Bankruptcy Code; most others file under Chapter 13.
In Chapter 7 the trustee liquidates all nonexempt assets--
although 96 percent of debtors have so little unencumbered
property that there is nothing left to liquidate. At the
conclusion of the bankruptcy, the debtor is freed from many
debts. In Chapter 13 the debtor proposes a repayment plan,
which extends for up to five years. Chapter 13 debtors may
retain their property so long as they stay current with their
repayments.
Under both chapters, taxes, student loans, alimony, and
child support remain payable in full, and debtors must make
payments on all secured loans (such as home mortgages and car
loans) or forfeit the collateral.
study data and methods
This study is based on a cohort of 1,771 bankruptcy filings
in 2001. For each filing, a debtor completed a written
questionnaire at the mandatory meeting with the trustee, and
we abstracted financial data from public court records. In
addition, we conducted follow-up telephone interviews with
about half (931) of these debtors.
Sampling strategy. We used cluster sampling to assemble a
cohort to households filing for personal bankruptcy in five
(of the seventy-seven total) federal judicial districts. We
collected 250 questionnaires in each district, representative
of the proportion of Chapters 7 and 13 filings in that
district. These 1,250 cases constitute our ``core sample.''
For planned studies on housing, we collected identical data
from an additional 521 homeowners filing for bankruptcy. We
based our analyses on all 1,771 bankruptcies with responses
weighted to maintain the representativeness of the sample.
Data collection. With the cooperation of the judges in each
district, we contacted the trustees who officiate at meetings
with debtors. The trustees agreed to distribute, or to allow
a research assistant to distribute, a self-administered
questionnaire to debtors appearing at the bankruptcy meeting.
Questionnaires (which were available in English and Spanish)
included a cover letter explaining the research project and
human subjects protections and encouraging debtors to consult
their attorneys (who were almost always present) before
participating.
The questionnaire asked about demographics, employment,
housing, and specific reasons for filing for bankruptcy, it
also asked whether the debtor had medical debts exceeding
$1,000, had lost two or more weeks of work-related income
because of illness, or had health insurance coverage for
themselves and all dependents at the time of filing, and
whether there had been a gap of one month or more in that
coverage during the past two years. In joint filings, we
collected demographic information for each spouse.
During the spring and summer of 2001 we collected
questionnaires from consecutive debtors in each district
until the target number was reached.
Follow-up telephone interviews. The written questionnaire
distributed at the time of bankruptcy filing invited debtors
to participate in future telephone interviews, for which they
would receive $50; 70 percent agreed to such interviews. We
ultimately completed follow-up telephone interviews with 931
of the 1,771 debtor families, a response rate of 53 percent.
The telephone interviews, conducted between June 2001 and
February 2002 using a structured, computer-assisted protocol,
explored financial, housing, and medical issues. Many debtors
also provided a narrative description of their bankruptcy
experience.
Detailed medical questions. Each of the 931 interviewees
was asked if any of the following had been a significant
cause of their bankruptcy: an illness or injury; the death of
a family member; or the addition of a family member through
birth, adoption, custody, or fostering. Those who answered
yes to this screening question were queried about diagnoses,
health insurance during the illness, and medical care use and
spending. Interviewers collected information about each
household member with medical problems. In total, we
collected in-depth medical information on 391 people with
health problems in 332 debtor households.
Data analysis. We used data from the self-administered
questionnaires (and court records) obtained from all 1,771
filters to analyze demographics, health coverage at the time
of filing, and gaps in coverage in the two years before
filing.
We also used the questionnaire to estimate how frequently
illness and medical bills contributed to bankruptcy. We
developed two summary measures of medical bankruptcy. Under
the rubric ``Major Medical Bankruptcy'' we included debtors
who either (1) cited illness or injury as a specific reason
for bankruptcy, or (2) reported uncovered medical bills
exceeding $1,000 in the past years,
or (3) lost at least two weeks of work-related income because
of illness/injury, or (4) mortgaged a home to pay medical
bills. Our more inclusive category, ``Any Medical
Bankruptcy,'' included debtors who cited any of the above, or
addiction, or uncontrolled gambling, or birth, or the death
of a family member.
Data from the 931 follow-up telephone interviews were used
to analyze hardships experienced by debtors in the period
surrounding their bankruptcy, including problems gaining
access to medical care. The in-depth medical interviews
regarding 391 people with medical problems are the basis for
our analyses of which household members were ill, diagnoses,
health insurance at onset of illness, and out-of-pocket
spending. Two physicians (Himmelstein and Woolhandler) coded
the diagnoses given by debtors into categories for analysis.
SAS and SUDAAN were used for statistical analyses,
adjusting for complex sample design. To extrapolate our
findings nationally, we assumed that our sample was
representative of the 1,457,572 households filing for
bankruptcy during 2001. Human subject committees at Harvard
Law School and the Cambridge Hospital approved the project.
study findings
Who files for bankruptcy? Exhibit 1 displays the
demographic characteristics of our weighted sample of 1,771
bankruptcy filers. The average debtor was a forty-one-year-
old woman with children and at least some college education.
Most debtors owned homes; their occupational prestige scores
place them predominantly in the middle or working classes.
On average, each bankruptcy involved 1.32 debtors
(reflecting some joint filings by married couples) and 1.33
dependents. Extrapolating from our data, the 1.5 million
personal bankruptcy filings nationally in 2001 involved 3.9
million people: 1.9 million debtors, 1.3 million children
under age eighteen, and 0.7 million other dependents.
Medical causes of bankruptcy. Exhibit 2 shows the