This 38-year-old mom's final wish was to buy up and 'destroy' other people's medical debt. Here's how it works and how to help.

At just 38, Casey McIntyre, a publishing executive remembered as an “adoring wife and mother,” died from ovarian cancer on Nov. 12. In a message written before her death that has subsequently gone viral on X (formerly Twitter), McIntyre shared her final wish: to pay off strangers' medical debt through the charity RIP Medical Debt.

“To celebrate my life, I've arranged to buy up others' medical debt and then destroy the debt," McIntyre, the publisher at the Penguin Random House imprint Razorbill, wrote. "I am so lucky to have had access to the best medical care at @MSKCancerCenter [Memorial Sloan Kettering Cancer Center] and am keenly aware that so many in our country don't have access to good care."

In his own X post, her husband, Andrew Rose Gregory, called the donation experience an "eye-opening look at both our power to eliminate medical debt and how fictional and made up so much crushing medical debt is." He also shared his plans to host a "debt jubilee" (with a possible bonfire) and memorial service for his wife next month.

To date, the RIP Medical Debt campaign founded in McIntyre’s name has raised $613,000 of its $650,000 goal — enough to wipe out more than $60 million of debt.

McIntyre’s campaign hits at the heart of a crisis affecting nearly half of Americans. Not only are many Americans struggling with access to quality care, but according to a new survey brief by the Commonwealth Fund, nearly half of adults in the U.S. (44%) have medical bill problems, regardless of income. And almost half of Americans (46%) with low or average incomes have skipped or delayed care they need because of the cost.

A separate survey from the Commonwealth Fund outlined how much medical debt Americans are carrying: 85% of respondents reported total debts of $500 or more, and nearly half said they were paying off $2,000 or more.

In the big picture, the most recent analysis from the Kaiser Family Foundation put the collective medical debt total in the United States at $195 billion.

How donations can eliminate medical debt

This growing issue is one of the driving forces behind RIP Medical Debt, which was founded in 2014 by former debt collection executives who realized they could take advantage of the existing for-profit system of medical debts being bought and sold in bundled portfolios for much less than their face value. “By using donor dollars, a nonprofit entity could buy medical debts belonging to those most in need and then effectively erase them,” explains Daniel Lempert, vice president of communications for RIP Medical Debt.

As Gregory noted online, "Every penny [donated} buys approximately $1" of debt. Why? Because doctors and hospitals often don’t have the bandwidth to collect on past-due debts, so they sell them to a collection agency in large portfolios for a fraction of their face value, often for pennies on the dollar or less, says Lempert. “A collection agency just needs to collect the face value of some of those debts to make a profit,” he explains.

That’s where RIP Medical Debt comes in. The charity puts donations toward the purchase of medical debt belonging to individuals who are the least likely to pay them back — specifically, people who are four times or below the federal poverty level or people for whom a debt is 5% or more of their annual income, Lempert tells Yahoo Life. And they’re able to do this for pennies on the dollar, which is how $1 donated can erase on average $100 of medical debt, he adds.

Once an individual’s medical debt has been eliminated, the nonprofit sends “letters out of the blue to people letting them know the good news.”

In addition to individual donations, the nonprofit is addressing the issue of medical debt in other ways. “We work with community partners to pair medical debt relief with other local services so individuals are less likely to have medical debt in the future,” says Lempert. “We also have a policy team that is advising the federal government and other partners on how best to tackle the burden of medical debt.” The organization has seen recent progress in that the Consumer Financial Protection Bureau is currently aiming to remove all medical debt from credit reports.

How you can get involved

Anyone can visit the RIP Medical Debt site and make a donation that will go toward national debt relief. And by visiting the charity’s campaign page, you can choose a specific geography-targeted campaign to donate to (like eliminating medical debt in Ohio or San Diego County, specifically) or even start your own, like McIntyre and her loved ones have.

Any community has the ability to set up a campaign. “We partner with high school students, community members, businesses, faith organizations like churches and others interested in lessening the burden of medical debt in their community,” says Lempert. “That said, we can only abolish medical debt geographically if we have enough qualifying debt available to us in the area, so we often encourage our campaign partners to think statewide.”

While every dollar counts, troubling statistics make it clear that this crisis is one that requires all hands on deck. “We know this isn't a problem we can fix alone,” says Lempert. “While our work is essential in helping people feel relief, we also fully acknowledge the need for structural change.”