Dan Weissmann
As premium funds for Affordable Care Act insurance coverage soar and cuts to Medicaid begin to have an effect on hospitals and sufferers, many individuals in 2026 will need assistance paying medical payments. And charity care could also be an answer.
One group engaged on that is Dollar For, a nonprofit targeted on serving to folks entry the monetary help that hospitals are legally required to supply sufferers who make lower than a specific amount.
An Arm and a Leg host Dan Weissmann checks again in with Dollar For founder Jared Walker about how his small group managed to assist erase greater than $55 million in medical payments final 12 months whereas navigating troublesome new funding challenges and ever-shifting political terrain.
Dan Weissmann
Host and producer of “An Arm and a Leg.” Previously, Dan was a employees reporter for Marketplace and Chicago’s WBEZ. His work additionally seems on All Things Considered, Marketplace, the BBC, 99 Percent Invisible, and Reveal, from the Center for Investigative Reporting.
Credits
Emily Pisacreta
Producer
Claire Davenport
Producer
Adam Raymonda
Audio wizard
Ellen Weiss
Editor
Click to open the Transcript
Transcript: ‘Sh**’s wild’: Scaling up, doubling down, and buckling in
Note: “An Arm and a Leg” makes use of speech-recognition software program to generate transcripts, which can include errors. Please use the transcript as a device however test the corresponding audio earlier than quoting the podcast.
Dan: Hey there.
So, 2026! On New Year’s Day, just about each morning information present had a not-so-good information story able to go.
News anchor: This morning, greater than 20 million Americans…
News anchor: …will see healthcare premiums double, triple, or go even larger…
News anchor: …after Congress failed to increase sure subsidies underneath the Affordable Care Act.
Dan: Lots of people will find yourself with out insurance coverage. Or with a lot crappier insurance coverage, as a result of they will’t afford something higher. Or paying much more for insurance coverage than they will afford. Or some combo platter.
And as a result of employer plans obtained dearer too — and a bunch of employers weren’t able to pay extra — plenty of of us ended up with insurance coverage from work that leaves them on the hook for extra.
All of it leaves much more folks much more weak this 12 months to overwhelming payments: for insurance coverage premiums, for medical care, for drugs.
So: I believed it might be a very good time to test in with one of many individuals who has given me essentially the most inspiration, and has taught me essentially the most about how we will push again in opposition to a few of this.
That can be Jared Walker, the founding father of the nonprofit Dollar For.
I first talked with Jared 5 years in the past, proper after he went super-viral on TikTookay sharing a secret that was hiding in plain sight:
Jared Walker: Most hospitals in America are nonprofits, which implies they need to have monetary help or charity care insurance policies. This is gonna sound bizarre, however what meaning is that when you make underneath a sure amount of cash, the hospital legally has to forgive your medical payments.
Dan: Millions of individuals saved watching as Jared rapidly demonstrated apply — after which wrapped up with a suggestion:
Jared Walker: I run a nonprofit that does this, so, uh, DM me and I’ll really do it for you. Let’s see if we will crush these medical payments.
Dan: Here’s what Jared mentioned to me a pair weeks later about that provide.
Jared Walker: Yeah, that was, that basically backfired. No, uh…
Dan: Thousands of individuals had gotten in contact to take him up on his provide. And Dollar For — a SUPER-tiny nonprofit that Jared had began to assist folks in his hometown of Portland, Oregon — instantly had a much bigger, nationwide mission that Jared was scrambling to satisfy.
Jared Walker: ?I’m excited. We’re gonna assist lots of people and, uh, hopefully we will get some funding to scale what we’re doing as a result of shit’s wild.
Dan: And it has been wild ever since.
Talking with Jared over the past 5 years — and watching the Dollar For crew scale up their ambitions and influence — it’s been one of the inspiring and eye-opening tales I’ve ever seen.
?So I used to be excited to speak with Jared a bit after New Years, to listen to how issues had been seeking to him in 2026.
I’d already seen the numbers: They helped folks wipe out 55 million {dollars} price of hospital payments in 2025 — an enormous improve from the 12 months earlier than.
Jared Walker: As far as influence goes, what we had been capable of do with the cash that we raised, like we’re rolling, like Dollar For is killing it
Dan: So I used to be shocked when Jared mentioned: 2025 had been robust.
Jared Walker: We began the 12 months with two of our greatest donors, principally simply backing out.
Dan: Some of the Trump administration’s early disruptive strikes– like trashing overseas help– had led these donors to re-think their priorities. Dollar For misplaced half one million {dollars} — nearly a 3rd of their price range. Suddenly Jared discovered himself scrambling to exchange it.
Jared Walker: Just making an attempt to, to make up that, $500,000, hole was, uh, enjoyable.
Dan: He managed to make up about 2 hundred thousand {dollars}. He says Dollar For didn’t lay anyone off, however some folks went to half time.
As the 12 months went on, extra political information pressured Jared and Dollar For to re-think *their* technique for 2025. It was one other scramble.
Meanwhile, Dollar For saved setting new information — wiping out two-thirds extra medical debt than the 12 months earlier than.
It’s left Jared and his colleagues considering onerous about how they chart their path in a world that’s nonetheless altering quick.
The story of the place they’ve been within the final 12 months — and what they’ve performed throughout the final 5 years — continues to assist me take into consideration the massive image like nothing else. So it’s an ideal place for this present to kick off 2026.
This is An Arm and a Leg a present about why well being care prices so freaking a lot and what we will possibly do about it. I’m Dan Weissmann — I’m a reporter, and I like a problem. So the job we’ve chosen on this present is to take one of the enraging, terrifying, miserable elements of American life, and produce you a present that’s entertaining, empowering, and helpful.
To return to the start for a minute. When I first talked with Jared 5 years in the past, he was already wanting on the large image. How large a distinction it might make if extra folks really obtained the charity care they certified for. Here he’s in January 2021.
Jared Walker: We’ve had thousands and thousands of individuals now which have declared chapter over medical payments that they legally didn’t even need to pay in the event that they knew about this. And that’s like – that ought to upset folks.
Dan: This is one purpose I discover Dollar For’s work so compelling — together with their scrappy method, and their accomplishments: from the beginning, they’ve all the time made the scope and the stakes of our well being care system’s dysfunction so clear, so stark.
But — speak about scrappy — after I had that first speak with Jared, he was scrambling to reply to the messages pouring in — 1000’s of them. He was grabbing whoever he may for assist.
Jared Walker: My niece is like 16. I used to be like, yo. Here’s my credentials. Get on right here and begin replying to folks.
Dan: Then, by the point I talked with him only a few months later, in the summertime of 2021, he had taken unimaginable steps to begin scaling up Dollar For, with assist from dozens of volunteers.
Including — particularly — of us who heard about him on this present.
Jared Walker: I used to be simply shocked at how many individuals had been reaching out saying, I, I heard you on this podcast, I heard you – and I’m like, nicely, I’ve solely been on one podcast, so I do know it’s this one.
Dan: Honestly, that is one other a part of what makes Dollar For my favourite story. Because it exhibits how many individuals are prepared to leap in and assist.
And how a lot individuals are able to contribute: In only a few months, Jared and a volunteer military — together with generals, a few wildly certified of us who put in near full-time hours for some time — had performed one thing unimaginable.
They’d constructed Dollar For a web site the place anybody, wherever within the nation, may test to see in the event that they certified for monetary help, and ask for assist making use of.
Because each hospital units its personal standards for who qualifies, organising that system meant grabbing the charity-care insurance policies from greater than two thousand totally different hospitals, and coding the entire standards right into a database.
The web site with that database went dwell in the summertime of 2021 — lower than six months after Jared first went viral on TikTookay.
He and his colleagues have been constructing and refining their operation ever since. And working in direction of making a big-picture distinction.
Last time I checked in with Jared, it was late 2024. Dollar For had put out a few analysis studies estimating the dimensions of that large image:
They discovered that lower than a 3rd of the individuals who certified for charity care really obtained their payments forgiven.
If all of these folks really obtained the charity care they certified for, Dollar For discovered that may imply 14 billion {dollars} in hospital payments, in medical debt, would vanish.
14 billion {dollars} that hospitals could possibly be forgiving underneath their very own insurance policies, yearly.
Jared undoubtedly observed that that quantity, 14 billion {dollars}, dwarfed the quantities Dollar For had been capable of deal with by working case by case. Like, they had been closing in on clearing 32 million {dollars} in hospital payments that 12 months. Which is a LOT for a tiny group. Jared was like…
Jared Walker: It sounds nice, and you then see the 14 billion quantity and also you’re like, oh, shoot. What are we doing? What are we doing?
Dan: Jared and his colleagues had began a strategic planning course of that may make them say: Let’s give attention to making a dent in that 14 billion {dollars} by advocating for brand new insurance policies. Laws to make hospitals a minimum of test to see if individuals are eligible for charity care earlier than chasing them for payments they will’t pay.
And whereas they had been planning, the bottom beneath them began to shift.
The Trump administration took workplace and amongst different issues, instantly began slashing overseas help.
?Newscaster 1: President Trump says he needs U-S-A-I-D, the aid company, serving to thousands and thousands of individuals all over the world to be shut down.
Newscaster 2: Just yesterday, U-S-A-I-D staff in Washington had been instructed to remain house.
Jared says a few of his donors reset their priorities — to fill in gaps internationally. One of them finalized their resolution simply as Dollar For was wrapping up their first board assembly of 2025.
Jared Walker: I get this electronic mail from our greatest donor saying, hey, we’re gonna minimize the 300K.
Dan: Oh wow.
Jared Walker: Um, and my board chair goes, Jared, what occurred to your face? Is all the things okay? And I used to be like, am I gonna inform my entire board proper right here proper now that we simply misplaced our greatest funder?
Dan: I requested Jared later by electronic mail: Hey, so did you spill the beans then? His response:
“lol. I did not tell them in that moment. My thought process was ‘ I don’t want to end our first board meeting of the year with this bomb. We are all hyped on the new year… let’s keep that energy. The board can’t change this email”
Jared stuffed them in later, and began hustling to fill the price range hole. They saved engaged on their strategic plan via the primary few months of 2025.
By the spring, they had been placing ending touches on it — after which the information cycle intervened once more.
Jared Walker: We went into 2025 with this concept of we’re going to do extra coverage work, we’re going to push extra coverage, we’re going to advocate for higher charity care legal guidelines, after which… Medicaid cuts, proper?
Dan: The Trump administration’s large legislative proposal — the “One Big Beautiful Bill” — aimed to offset large tax cuts partially with large cuts to Medicaid spending.
Newscaster: Republicans need to slash two trillion {dollars} – with a T– in long run spending. And Medicaid could possibly be a goal.
Dan: And a ton of these Medicaid {dollars} go to hospitals.
Jared Walker: And if you find yourself getting each single headline is ‘Woe is me, we’re a hospital, we’re not gonna make it. You’re gonna bankrupt hospitals…’
Dan: That was gonna make pushing new guidelines for hospitals — forcing them to be extra beneficiant — a harder promote.
And right here’s the place these two tales — Dollar For will get hit by large, fast-moving adjustments in 2025, and two: Dollar For wipes out much more medical debt than ever earlier than in 2025 — we’re gonna see the place they intersect.
That’s coming proper up.
This episode of An Arm and a Leg is a co manufacturing of Public Road Productions and KFF Health News. That’s a nonprofit newsroom overlaying well being points in America.
With all of those big-picture adjustments — like cuts to Medicaid –Dollar For determined to pivot.
Jared Walker: we form of slowed down and mentioned, okay, if individuals are gonna lose Medicaid, if individuals are gonna, if their insurance coverage premiums are gonna go up, if all this stuff, what we have to do is we have to double down on direct service and assist extra as many sufferers as we will as a result of the urge for food for coverage change may not be there.
Dan: They had a communications and advertising crew who had deliberate to spend the 12 months pushing Dollar For’s coverage message.
Instead, they targeted on spreading the phrase about charity care and Dollar For. Pitching Jared to reporters. It labored. He says he was featured in additional than 90 information tales earlier than the 12 months was out.
Jared Walker: I used to be on extra podcasts than I’ve ever been on, ever, doing native information stuff. So the advertising crew was cooking fairly good so far as getting the phrase out.
Dan: That meant extra of us coming to Dollar For on the lookout for assist with charity care. Which is one factor that drove up the variety of folks Dollar For was capable of assist.
The different was the payoff on a long-term funding.
In the spring of final 12 months they completed a undertaking they’d been engaged on for a very long time: Making it straightforward for sufferers to fill out a charity care software straight on Dollar For’s web site.
Jared Walker: A affected person goes to dollarfor.org. They fill out family measurement earnings, what hospital it tells ’em in the event that they’re eligible. If they’re, it bounces them proper right into a digital software. They can do this on their cellphone, pill, pc. They’re filling it out and it’s robotically mapping their information into the proper hospital kind.
Dan: This is the massive improve: I don’t need to observe a hyperlink to the hospital’s web site and discover their kind. I don’t need to print something out.
I’m staying on Dollar For’s user-friendly web site, answering questions from my hospital’s software kind — as a result of each hospital’s kind is totally different, and a few ask for extra data than others, the back-end work by Dollar For to provide me the fitting questions? That’s a giant deal.
And: The Dollar For crew is placing these inquiries to me in plain, user-friendly English. Which not each hospital kind essentially does. If I get caught, I message the Dollar For crew to get assist, straight.
When I’m performed, it exhibits me the outcomes and says:
Jared Walker: Here’s your accomplished software. Does all the things look good? thumbs-up it, we submit it to the hospital, after which we do observe up from there
Dan: Jared says additionally they created a portal the place sufferers can test on the standing of their software, and bounce proper right into a chat with a affected person advocate.
I used to be like: You know, that’s fairly spectacular. Your 12 months didn’t completely suck.
Jared Walker: Yeah. It is truthfully like, you’re like reminding me of, I’m like, oh yeah, we did some, we did some actually cool stuff final 12 months.?
Dan: And he sees room for brand new tech to assist them get much more environment friendly — sure, with assist from AI.
Jared Walker: ?And like, we’re very a lot within the camp of it is a useful gizmo, it’s not gonna clear up all of our issues
Dan: But he does see a couple of areas the place it may assist.
Including — serving to his crew do one thing they really haven’t had the capability, just like the time, to do but: high quality management on the paperwork sufferers submit with their purposes– like proof of earnings.
Jared Walker: Sometimes folks by accident add a, you understand, an image of their cat as a substitute of their, you understand, W2 or, or no matter. So if we may have an AI device, scan the doc and guarantee that it matches with what they mentioned…
Dan: And flag conditions the place a human at Dollar For ought to have a look earlier than sending it in…
Jared Walker: that may additionally save us a bunch of backwards and forwards with the hospital and the affected person
Dan: In different phrases, save time for everybody. And possibly assist Dollar For’s rep with hospitals.
Jared Walker: It form of makes us look unhealthy if we ship paperwork to a hospital and it’s a photograph of any person’s cat, you understand?
Dan: That would value cash – Jared estimates 1 / 4 of one million {dollars}, together with the price of including Dollar For’s first full-time CTO.
Meanwhile, they haven’t stopped pushing for coverage change. In 2025, Dollar For printed a examine that form of turned the telescope round on the query it had addressed the 12 months earlier than. If hospitals gave monetary help to everybody who certified, they’d discovered it might save sufferers 14 billion {dollars} a 12 months.
This time, they requested: how a lot of a success would that 14 billion {dollars} be to the underside line for America’s hospitals? How a lot of their earnings would they be dropping?
Dollar For’s reply: zero level seven %.
Jared Walker: Like, this is sort of a fraction of, a fraction of what these hospitals usher in.
Dan: Not all hospitals, as Jared is fast to notice.
Jared Walker: Like, there’s, you understand, 8,000 hospitals in America and so they’re not all equal. There are large hospitals, there are small hospitals. Obviously, it’s very onerous to, you understand, generalize this stuff.
Dan: Like we’ve talked about right here earlier than: Some hospitals actually ARE on the verge of going underneath. And some have revenue margins of greater than thirty %. And there’s all the things in between.
But right here’s the quantity that basically jumped out at me from that Dollar For report. It’s not simply the quantity of charity care that hospitals withhold is principally tiny in comparison with their total income.
The whole quantity of earnings hospitals get straight from sufferers’ pockets — all of the payments I hear about on this present, and that everyone knows are on the market, the payments that drive folks into debt, out of business…
All of that cash, all of that struggling represents simply 2.5% of what hospitals receives a commission for care, in accordance with KFF information that Dollar For cites Two level 5 %.
I don’t have a extremely deep perception right here, however this quantity jolts me again to consciousness of how large this health-care industrial complicated is. And how a lot its dysfunction prices our entire society.
Like, zoom out. We spent 5 TRILLION {dollars} a 12 months on these things — and so many individuals nonetheless don’t get the well being care they want.
It jogs my memory that — together with understanding methods we might help ourselves and one another — particular person, day-to-day methods — it’s necessary to know why well being care prices so freaking a lot. Where all that cash goes, what we will possibly do about it.
Meanwhile, again to Jared and the way he sees issues moving into 2026.
Jared Walker: Health care goes to worsen. Health care goes to be extra unaffordable than it was. Health care goes to place extra folks out of business, extra folks into a foul monetary state of affairs.
Dan: Which makes the necessity for Dollar For’s work extra apparent. Dollar For isn’t at risk of going away.
But the entire fast change within the final 12 months — the accomplishments and the setbacks — has Jared considering onerous about maintain shifting ahead over the lengthy haul.
Jared Walker: Dollar For has simply been so scrappy. We’ve simply been so scrappy, you understand. I don’t need to be the, you understand, the unpaid intern group that’s identical to, you understand, burning everyone out. I need to have the ability to pay folks nicely. I wanna be capable of present unimaginable healthcare advantages. I wanna be capable of have a 401k match. Like, I need folks to thrive at Dollar For.
Dan: That’s the way you be certain that folks can stick round and continue to grow, and determining make the largest influence in a wild setting.
As we wound up our dialog, I wished to inform Jared about how An Arm and a Leg’s 2025 had gone. Partly as a result of I believed it’d cheer him up a bit bit.
So I instructed him about how a medical scholar named Thomas Sanford had put collectively a useful resource information for sufferers primarily based on our reporting, and began handing it out. How different listeners had been serving to refine it.
How we’d put a model on our web site — prompted by Thomas’s concept that well being care employees may embellish the “badge reels” on their lanyards with a QR code sufferers may scan.
Jared Walker: Yeah. Putting it on the lanyard. I like it. And it’s simply one thing that we want extra of is like, how can we empower the affected person and the healthcare employee and the folks which might be, you understand, as much as combat it.
Dan: That’s it proper there. The place we’re in proper now — simply with well being care, the massive image can look actually scary. Trying to tackle the entire thing — heck, simply making an attempt to take in the entire thing, the massive image– it’s lots.
And it doesn’t imply we cease making an attempt. But we’re not individually accountable for fixing the entire thing straight away. And we will discover issues to do — methods to assist ourselves and one another IN THE MEANTIME.
Like through the use of the sorts of issues we be taught right here to take a bit extra management over our personal lives — and serving to different folks take management over theirs.
We spent plenty of the final couple of months asking you to assist us maintain doing our work– and you actually got here via. A number of you included notes along with your donations, unimaginable, heartening notes.
I’m gonna share one right here — we really shared it within the First Aid Kit publication final week — however I’m repeating it as a result of it illustrates one thing:
“This amount, $85.23, is the amount I avoided paying because you taught me how to take notes when speaking to my insurance company, always getting the name of the representative and the call reference number.”
And right here’s what I take from that: Every time any of us will get again a bit capability — saves a bit cash, saves some fear — from a system that threatens to overwhelm us…
That’s capability we will put to make use of. To nourish ourselves and one another. To financial institution some new power. And issues that appear small — saving 85 {dollars}. Telling somebody about Dollar For and serving to them hook up with charity care. There’s no technique to know in the event that they’ll add as much as ENOUGH to maneuver ourselves towards the structural change we want. But each bit actually does depend.
So: Thank you once more. For listening. For sharing what you understand — I discovered about Dollar For as a result of listeners to this present noticed Jared’s TikTookay and made certain to inform me about it. And for doing what you possibly can for your self, and your loved ones, and the folks round you.
We’ll have a brand new episode for you in a couple of weeks.
Till then, care for your self.
This episode of An Arm and a Leg was produced me, Dan Weissmann, with assist from Emily Pisacreta — and edited by Ellen Weiss.
Adam Raymonda is our audio wizard.
Our music is by Dave Weiner and Blue Dot Sessions.
Claire Davenport is our engagement producer.
Sarah Ballema is our Operations Manager. Bea Bosco is our consulting director of operations.
An Arm and a Leg is produced in partnership with KFF Health News. That’s a nationwide newsroom producing in-depth journalism about well being points in America and a core program at KFF, an impartial supply of well being coverage analysis, polling, and journalism.
Zach Dyer is senior audio producer at KFF Health News. He’s editorial liaison to this present.
An Arm and a Leg is distributed by KUOW, Seattle’s NPR information station.
And due to the Institute for Nonprofit News for serving as our fiscal sponsor.
They permit us to just accept tax-exempt donations. You can be taught extra about INN at INN.org.
Finally, thanks to everyone who helps this present financially.
You can take part any time at arm and a leg present, dot com, slash: assist.
[Names redacted for web transcript.]
“An Arm and a Leg” is a co-production of KFF Health News and Public Road Productions.
For extra from the crew at “An Arm and a Leg,” subscribe to its weekly publication, First Aid Kit. You may observe the present on Facebook, Instagram, LinkedIn, and Bluesky. And when you’ve obtained tales to inform concerning the well being care system, the producers would like to hear from you.
To hear all KFF Health News podcasts, click here.
And subscribe to “An Arm and a Leg” on Spotify, Apple Podcasts, Pocket Casts, or wherever you hearken to podcasts.
src=”//platform.twitter.com/widgets.js” charset=”utf-8″>