Bill to discharge medical debt incurred in prison wins broad support at Senate hearing

Senate Bill 88 would require the discharge of outstanding medical debt incurred while a person was incarcerated when that person is released, sponsors and witnesses told the Senate Judiciary Committee during a public hearing.

Sponsor Melanie Scheibel said the bill grew out of the interim judiciary committee and is intended to help people returning from prison reenter the workforce and housing without being saddled by medical bills they incurred while incarcerated. "SB 88 is another product of the interim committee on judiciary," Scheibel said when she introduced the measure and turned the hearing over to advocates and a person who said he was personally impacted.

Nick Shepack, Nevada state director of the Fines and Fees Justice Center, told the committee that more than $13,000,000 in outstanding medical debt is owed by people formerly incarcerated in Nevada and that collection yields have been low. Shepack said the Department of Corrections spent roughly $6,000 on collection attempts and that in the most recent year the program returned $174.91 net, figures Shepack attributed to Department of Corrections conversations. He described the financial impact on people released from custody and read the contents of a demand letter: it sought $7,216 with a 30‑day deadline and threatened collection action and added costs if unpaid.

Frank Macias described his own experience: while incarcerated he said he suffered a wrist injury that he and treating clinicians said was not properly treated in time, which led to later surgery and a long-term impairment. Macias said he was billed about $8,000 while in custody, that commissary funds were withheld leaving him $25 at release, and that after release he received a letter demanding $7,200 within 30 days or face collections. "It's impossible for almost all of these individuals to pay this legally," Shepack said while describing how the debt balloons once it goes to collections.

Representatives from reentry and legal-aid organizations spoke in support. Denise Bolanos Herredia of Return Strong Nevada, Harrison Epstein of the Clark County Public Defender's Office, Angela Knott of the Washoe County Public Defender's Office, and others said the debt is a barrier to housing and employment and increases the risk of recidivism. Shane Piccinini of the Food Bank of Northern Nevada and Carissa Pierce of Children's Advocacy Alliance said the debt harms families and children by reducing resources available for rent, food and childcare.

Committee members questioned cost and operational impacts. Senator Hansen and others asked whether the bill intended to shift costs to Medicaid or whether federal programs would be billed; witnesses clarified that prior legislation requires eligible individuals be enrolled in Medicaid before release but that eligibility and coverage timing vary. Medical administrator Russell Alfano of the Nevada Department of Corrections testified that the department has no dedicated staff solely assigned to debt collection and that the roughly $5,400 figure referenced for collection efforts reflects postage and staff time; Alfano said only outside medical-provider charges are passed to an offender in custody.

Senator Wynne and others asked whether the bill could be retroactive. Director James Zurenda of the Nevada Department of Corrections said the department is not opposed to retroactivity; sponsor Scheibel said she would welcome an amendment to make the bill retroactive so people like Macias could benefit.

No formal vote was held. Supporters urged the committee to advance the bill, and several witnesses emphasized that the state collects little of the debt while the bills continue to harm reentry prospects.