Alex Olgin

Two and a half million North Carolinians got a surprise last year.

Their medical debt was erased.

60-year-old Dawn Daly-Mack says when she received the letter for a $459 emergency room visit, she was in disbelief.

It was all part of a deal the state's 99 hospitals agreed to in exchange for a boost in Medicaid dollars.

They also pledged to automatically discount care for patients who qualify for financial assistance going forward.

Several states have stepped up medical debt protections in recent years.

Meanwhile, the federal government rolled back plans to keep medical debt off credit reports.

For NPR News, I'm Alex Olgin.