Rachel White thought she had good healthcare insurance. A Hawthorne resident, she worked surrounded by nurses and doctors as a custodian at UF Health Shands Hospital in Gainesville. 

But after a car accident left her in a multi-day coma, she ended up with $30,000 in medical debt. 

Dr. Frederick Southwick said medical debt is a reality for many Americans, whether insured or not. He’s spent decades in the medical field, working at UF Health and teaching courses in the College of Medicine.  

He started a local chapter of Right Care Alliance to help improve the healthcare system. The group started by fighting against high insulin prices, and he said the group has now shifted to medical debt.  

On Saturday, Southwick, White and a handful of other Hawthorne area residents met to discuss medical debt and helpful resources at First United Methodist Church. 

“Because they’re in debt, often the health system they’re in debt to won’t see them anymore or they’re afraid to go anywhere else because they can accumulate more debt,” Southwick said.  

UF students presented information from national studies.  

According to the KFF Health Care Debt Survey, more than 41% of American adults have medical debt. Around 1 in 4 of those adults owe at least $5,000. The study said the actual numbers could be higher since medical debt is often disguised as credit card debt or loans from family. 

Southwick said the impact is especially felt in rural areas like Hawthorne and it goes beyond having another monthly bill to pay. He said people in medical debt may start cutting back on food, start skipping preventative care or try to stretch medications to last longer.  

These rural areas are further from hospitals and lack options, or any, specialty care. They can also be poorer. Alachua County and Hawthorne’s poverty level is higher than the state average.  

Sharon Surrency said she deals with local residents facing healthcare issues daily at the Hawthorne Area Resource Center, which started in 2016 with support from local churches and citizens.  

Surrency worked as a nurse and now serves as a pastor at First United Methodist Church. She said she’s seen the deficiencies in the current system across all those fields.    

The center assists as it can, even if it’s just giving advice or pointing to other organizations with the right resources. The center also serves as a food bank and works on other issues. 

She said the center has grown through word of mouth from helping 30 families a week to around 1,100 families per month. 

Surrency said a lot of the people have Medicaid and Medicare and, depending on the plan, their coverage may be complete or it may have gaps. The center also tries to help those in medical debt. 

“We don’t have a lot of funds, but when we do have funds, we try to help them with something—just to get the bill collectors off their back for a little bit,” Surrency said.  

At the town hall, Southwick points out that Florida is one of 10 states that decided not to expand Medicaid. He said that means a family of three on Medicaid is left in a “ridiculous” situation since they can’t have an annual income above $8,000.  

A main goal of Right Care Alliance is to get Florida to allow expanded Medicaid. The group is collecting signatures for Florida Decides Healthcare, a statewide organization pushing to place the expanded Medicaid question before voters in 2026.  

If expanded Medicaid is passed, it would be available for adults making below 138% of the federal poverty level—$20,120 for a single-person household. 

With expanded Medicaid, Southwick said UF Health may have been able to keep facilities in rural areas.  

However, he said Americans need to shift their perspective, from viewing healthcare as a privilege to a right. That shift would bring other changes to help the system, and its patients.  

Until then, Southwick said Right Care Alliance and partners like the Hawthorne Area Resource Center want to keep holding health events in rural areas to spread information and help people make better choices within the current system. 

“It does seem impossible sometimes, but I try to focus on the success stories we’ve had and the benefit that’s been received by those people who are part of those success stories, even if it’s just one family at a time or one person at a time,” Surrency said.