Philanthropist MacKenzie Scott’s donations to nonprofit Undue Medical Debt have helped expand an approach that has now eliminated more than $40 billion in medical debt across the United States, highlighting how charitable capital is being used to purchase and cancel unpaid healthcare bills.
Scott has donated a total of $130 million to Undue Medical Debt since 2020, according to the nonprofit and previous reporting. Her contributions came through three gifts, beginning with $50 million in 2020, followed by $30 million in 2022 and another $50 million announced in December 2024.
The organisation, previously known as RIP Medical Debt, buys portfolios of qualifying medical debt from hospitals, healthcare providers and other debt holders at substantial discounts. Instead of attempting to recover the money from patients, it cancels the debt.
The model allows donated funds to erase debt with a face value considerably higher than the amount spent acquiring it. Undue has previously said that one donated dollar can, on average, eliminate about $100 of medical debt, although the impact varies depending on individual debt portfolios.
Scott’s support has helped the nonprofit expand its operations at a time when medical debt remains a financial burden for millions of Americans. Undue Medical Debt says it has now abolished more than $40 billion in medical debt across all 50 US states.
The approach has also attracted support from other high-profile donors. Snap co-founder Evan Spiegel and Miranda Kerr recently made a donation that helped erase more than $550 million in medical debt for over 261,000 people in California.
Scott’s medical debt giving forms part of a broader philanthropic programme. Following her divorce from Amazon founder Jeff Bezos, she received a 4% stake in Amazon and has since sold down part of her holding. She has donated more than $26 billion to over 2,500 organisations across areas including education, economic equity, public health and environmental causes.
The medical debt model has also expanded beyond individual philanthropy. State and local governments have partnered with Undue Medical Debt on relief programmes. In August, Arizona Governor Katie Hobbs announced that more than $1 billion in medical debt had been erased for 670,963 residents through a partnership with the nonprofit.
However, debt cancellation addresses existing obligations rather than the underlying factors that produce medical debt. Undue itself has expanded its work into research and policy initiatives aimed at addressing the wider problem.
Scott’s contributions demonstrate the scale that the debt-purchasing model can achieve, while the continued growth of medical debt relief programmes underscores the broader challenge of healthcare affordability in the US.
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