As premium payments for Affordable Care Act insurance plans soar and cuts to Medicaid start to affect hospitals and patients, many people in 2026 will need help paying medical bills. And charity care may be a solution.
One group working on this is Dollar For, a nonprofit focused on helping people access the financial assistance that hospitals are legally required to offer patients who make less than a certain amount.
An Arm and a Leg host Dan Weissmann checks back in with Dollar For founder Jared Walker about how his small organization managed to help erase more than $55 million in medical bills last year while navigating difficult new funding challenges and ever-shifting political terrain.
Dan Weissmann
Host and producer of “An Arm and a Leg.” Previously, Dan was a staff reporter for Marketplace and Chicago’s WBEZ. His work also appears on All Things Considered, Marketplace, the BBC, 99 Percent Invisible, and Reveal, from the Center for Investigative Reporting.
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Transcript: ‘Sh**’s wild’: Scaling up, doubling down, and buckling in
Note: “An Arm and a Leg” uses speech-recognition software to generate transcripts, which may contain errors. Please use the transcript as a tool but check the corresponding audio before quoting the podcast.
Dan: Hey there.
So, 2026! On New Year’s Day, pretty much every morning news show had a not-so-good news story ready to go.
News anchor: This morning, more than 20 million Americans…
News anchor: …will see healthcare premiums double, triple, or go even higher…
News anchor: …after Congress failed to extend certain subsidies under the Affordable Care Act.
Dan: A lot of people will end up without insurance. Or with much crappier insurance, because they can’t afford anything better. Or paying a lot more for insurance than they can afford. Or some combo platter.
And because employer plans got more expensive too — and a bunch of employers weren’t ready to pay more — lots of folks ended up with insurance from work that leaves them on the hook for more.
All of it leaves a lot more people a lot more vulnerable this year to overwhelming bills: for insurance premiums, for medical care, for medicine.
So: I thought it would be a good time to check in with one of the people who has given me the most inspiration, and has taught me the most about how we can push back against some of this.
That would be Jared Walker, the founder of the nonprofit Dollar For.
I first talked with Jared five years ago, right after he went super-viral on TikTok sharing a secret that was hiding in plain sight:
Jared Walker: Most hospitals in America are nonprofits, which means they have to have financial assistance or charity care policies. This is gonna sound weird, but what that means is that if you make under a certain amount of money, the hospital legally has to forgive your medical bills.
Dan: Millions of people kept watching as Jared quickly demonstrated how to apply — and then wrapped up with an offer:
Jared Walker: I run a nonprofit that does this, so, uh, DM me and I will actually do it for you. Let’s see if we can crush those medical bills.
Dan: Here’s what Jared said to me a couple weeks later about that offer.
Jared Walker: Yeah, that was, that really backfired. No, uh…
Dan: Thousands of people had gotten in touch to take him up on his offer. And Dollar For — a SUPER-tiny nonprofit that Jared had started to help people in his hometown of Portland, Oregon — suddenly had a bigger, national mission that Jared was scrambling to meet.
Jared Walker: ?I’m excited. We’re gonna help a lot of people and, uh, hopefully we can get some funding to scale what we’re doing because shit’s wild.
Dan: And it has been wild ever since.
Talking with Jared over the last five years — and watching the Dollar For team scale up their ambitions and impact — it’s been one of the most inspiring and eye-opening stories I’ve ever seen.
?So I was excited to talk with Jared a little after New Years, to hear how things were looking to him in 2026.
I’d already seen the numbers: They helped people wipe out 55 million dollars worth of hospital bills in 2025 — a huge increase from the year before.
Jared Walker: As far as impact goes, what we were able to do with the money that we raised, like we’re rolling, like Dollar For is killing it
Dan: So I was surprised when Jared said: 2025 had been tough.
Jared Walker: We started the year with two of our biggest donors, basically just backing out.
Dan: Some of the Trump administration’s early disruptive moves– like trashing foreign aid– had led those donors to re-think their priorities. Dollar For lost half a million dollars — almost a third of their budget. Suddenly Jared found himself scrambling to replace it.
Jared Walker: Just trying to, to make up that, $500,000, gap was, uh, fun.
Dan: He managed to make up about two hundred thousand dollars. He says Dollar For didn’t lay anybody off, but some people went to half time.
As the year went on, more political news forced Jared and Dollar For to re-think *their* strategy for 2025. It was another scramble.
Meanwhile, Dollar For kept setting new records — wiping out two-thirds more medical debt than the year before.
It’s left Jared and his colleagues thinking hard about how they chart their path in a world that’s still changing fast.
The story of where they’ve been in the last year — and what they’ve done across the last five years — continues to help me think about the big picture like nothing else. So it’s a great place for this show to kick off 2026.
This is An Arm and a Leg a show about why health care costs so freaking much and what we can maybe do about it. I’m Dan Weissmann — I’m a reporter, and I like a challenge. So the job we’ve chosen on this show is to take one of the most enraging, terrifying, depressing parts of American life, and bring you a show that’s entertaining, empowering, and useful.
To go back to the beginning for a minute. When I first talked with Jared five years ago, he was already looking at the big picture. How big a difference it would make if more people actually got the charity care they qualified for. Here he is in January 2021.
Jared Walker: We’ve had millions of people now that have declared bankruptcy over medical bills that they legally didn’t even have to pay if they knew about this. And that’s like – that should upset people.
Dan: This is one reason I find Dollar For’s work so compelling — along with their scrappy approach, and their accomplishments: from the start, they’ve always made the scope and the stakes of our health care system’s dysfunction so clear, so stark.
But — talk about scrappy — when I had that first talk with Jared, he was scrambling to respond to the messages pouring in — thousands of them. He was grabbing whoever he could for help.
Jared Walker: My niece is like 16. I was like, yo. Here’s my credentials. Get on here and start replying to people.
Dan: Then, by the time I talked with him just a few months later, in the summer of 2021, he had taken incredible steps to start scaling up Dollar For, with help from dozens of volunteers.
Including — especially — folks who heard about him on this show.
Jared Walker: I was just shocked at how many people were reaching out saying, I, I heard you on this podcast, I heard you – and I’m like, well, I’ve only been on one podcast, so I know it’s this one.
Dan: Honestly, this is another part of what makes Dollar For my favorite story. Because it shows how many people are ready to jump in and help.
And how much people are ready to contribute: In just a few months, Jared and a volunteer army — including generals, a couple of wildly qualified folks who put in close to full-time hours for a while — had done something incredible.
They’d built Dollar For a website where anyone, anywhere in the country, could check to see if they qualified for financial assistance, and ask for help applying.
Because every hospital sets its own criteria for who qualifies, setting up that system meant grabbing the charity-care policies from more than two thousand different hospitals, and coding all of the criteria into a database.
The website with that database went live in the summer of 2021 — less than six months after Jared first went viral on TikTok.
He and his colleagues have been building and refining their operation ever since. And working towards making a big-picture difference.
Last time I checked in with Jared, it was late 2024. Dollar For had put out a couple of research reports estimating the size of that big picture:
They found that less than a third of the people who qualified for charity care actually got their bills forgiven.
If all of those people actually got the charity care they qualified for, Dollar For found that would mean 14 billion dollars in hospital bills, in medical debt, would vanish.
14 billion dollars that hospitals could be forgiving under their own policies, every year.
Jared definitely noticed that that number, 14 billion dollars, dwarfed the amounts Dollar For had been able to address by working case by case. Like, they were closing in on clearing 32 million dollars in hospital bills that year. Which is a LOT for a tiny organization. Jared was like…
Jared Walker: It sounds great, and then you see the 14 billion number and you’re like, oh, shoot. What are we doing? What are we doing?
Dan: Jared and his colleagues had started a strategic planning process that would lead them to say: Let’s focus on making a dent in that 14 billion dollars by advocating for new policies. Laws to make hospitals at least check to see if people are eligible for charity care before chasing them for bills they can’t pay.
And while they were planning, the ground beneath them started to shift.
The Trump administration took office and among other things, immediately started slashing foreign aid.
?Newscaster 1: President Trump says he wants U-S-A-I-D, the relief agency, helping millions of people around the world to be shut down.
Newscaster 2: Just yesterday, U-S-A-I-D employees in Washington were told to stay home.
Jared says some of his donors reset their priorities — to fill in gaps internationally. One of them finalized their decision just as Dollar For was wrapping up their first board meeting of 2025.
Jared Walker: I get this email from our biggest donor saying, hey, we’re gonna cut the 300K.
Dan: Oh wow.
Jared Walker: Um, and my board chair goes, Jared, what happened to your face? Is everything okay? And I was like, am I gonna tell my whole board right here right now that we just lost our biggest funder?
Dan: I asked Jared later by email: Hey, so did you spill the beans then? His response:
“lol. I did not tell them in that moment. My thought process was ‘ I don’t want to end our first board meeting of the year with this bomb. We are all hyped on the new year… let’s keep that energy. The board can’t change this email”
Jared filled them in later, and started hustling to fill the budget gap. They kept working on their strategic plan through the first few months of 2025.
By the spring, they were putting finishing touches on it — and then the news cycle intervened again.
Jared Walker: We went into 2025 with this idea of we are going to do more policy work, we’re going to push more policy, we’re going to advocate for better charity care laws, and then… Medicaid cuts, right?
Dan: The Trump administration’s big legislative proposal — the “One Big Beautiful Bill” — aimed to offset big tax cuts in part with big cuts to Medicaid spending.
Newscaster: Republicans are looking to slash two trillion dollars – with a T– in long term spending. And Medicaid could be a target.
Dan: And a ton of those Medicaid dollars go to hospitals.
Jared Walker: And when you are getting every single headline is ‘Woe is me, we’re a hospital, we’re not gonna make it. You’re gonna bankrupt hospitals…’
Dan: That was gonna make pushing new rules for hospitals — forcing them to be more generous — a tougher sell.
And here’s where these two stories — Dollar For gets hit by big, fast-moving changes in 2025, and two: Dollar For wipes out a lot more medical debt than ever before in 2025 — we’re gonna see where they intersect.
That’s coming right up.
This episode of An Arm and a Leg is a co production of Public Road Productions and KFF Health News. That’s a nonprofit newsroom covering health issues in America.
With all of these big-picture changes — like cuts to Medicaid –Dollar For decided to pivot.
Jared Walker: we kind of slowed down and said, okay, if people are gonna lose Medicaid, if people are gonna, if their insurance premiums are gonna go up, if all these things, what we need to do is we need to double down on direct service and help more as many patients as we can because the appetite for policy change might not be there.
Dan: They had a communications and marketing team who had planned to spend the year pushing Dollar For’s policy message.
Instead, they focused on spreading the word about charity care and Dollar For. Pitching Jared to reporters. It worked. He says he was featured in more than 90 news stories before the year was out.
Jared Walker: I was on more podcasts than I’ve ever been on, ever, doing local news stuff. So the marketing team was cooking pretty good as far as getting the word out.
Dan: That meant more folks coming to Dollar For looking for help with charity care. Which is one thing that drove up the number of people Dollar For was able to help.
The other was the payoff on a long-term investment.
In the spring of last year they finished a project they’d been working on for a long time: Making it easy for patients to fill out a charity care application directly on Dollar For’s website.
Jared Walker: A patient goes to dollarfor.org. They fill out household size income, what hospital it tells ’em if they’re eligible. If they are, it bounces them right into a digital application. They can do that on their phone, tablet, computer. They’re filling it out and it is automatically mapping their data into the correct hospital form.
Dan: This is the big upgrade: I don’t have to follow a link to the hospital’s website and find their form. I don’t have to print anything out.
I’m staying on Dollar For’s user-friendly site, answering questions from my hospital’s application form — because every hospital’s form is different, and some ask for more information than others, the back-end work by Dollar For to give me the right questions? That’s a big deal.
And: The Dollar For team is putting those questions to me in plain, user-friendly English. Which not every hospital form necessarily does. If I get stuck, I message the Dollar For team to get help, directly.
When I’m done, it shows me the results and says:
Jared Walker: Here’s your completed application. Does everything look good? thumbs-up it, we submit it to the hospital, and then we do follow up from there
Dan: Jared says they also created a portal where patients can check on the status of their application, and jump right into a chat with a patient advocate.
I was like: You know, that’s pretty impressive. Your year did not totally suck.
Jared Walker: Yeah. It is honestly like, you’re like reminding me of, I’m like, oh yeah, we did some, we did some really cool stuff last year.?
Dan: And he sees room for new tech to help them get even more efficient — yes, with help from AI.
Jared Walker: ?And like, we’re very much in the camp of this is a great tool, it’s not gonna solve all of our problems
Dan: But he does see a few areas where it could help.
Including — helping his team do something they actually haven’t had the capacity, like the time, to do yet: quality control on the documents patients submit with their applications– like proof of income.
Jared Walker: Sometimes people accidentally upload a, you know, a picture of their cat instead of their, you know, W2 or, or whatever. So if we could have an AI tool, scan the document and make sure that it matches with what they said…
Dan: And flag situations where a human at Dollar For should take a look before sending it in…
Jared Walker: that would also save us a bunch of back and forth with the hospital and the patient
Dan: In other words, save time for everyone. And maybe help Dollar For’s rep with hospitals.
Jared Walker: It kind of makes us look bad if we send documents to a hospital and it’s a photo of somebody’s cat, you know?
Dan: That would cost money – Jared estimates a quarter of a million dollars, including the cost of adding Dollar For’s first full-time CTO.
Meanwhile, they haven’t stopped pushing for policy change. In 2025, Dollar For published a study that kind of turned the telescope around on the question it had addressed the year before. If hospitals gave financial assistance to everyone who qualified, they’d found it would save patients 14 billion dollars a year.
This time, they asked: how much of a hit would that 14 billion dollars be to the bottom line for America’s hospitals? How much of their income would they be losing?
Dollar For’s answer: zero point seven percent.
Jared Walker: Like, this is like a fraction of, a fraction of what these hospitals bring in.
Dan: Not all hospitals, as Jared is quick to note.
Jared Walker: Like, there’s, you know, 8,000 hospitals in America and they’re not all equal. There are big hospitals, there are small hospitals. Obviously, it’s very hard to, you know, generalize these things.
Dan: Like we’ve talked about here before: Some hospitals really ARE on the verge of going under. And some have profit margins of more than thirty percent. And there’s everything in between.
But here’s the number that really jumped out at me from that Dollar For report. It’s not just the amount of charity care that hospitals withhold is basically tiny compared to their overall revenue.
The total amount of income hospitals get directly from patients’ pockets — all the bills I hear about on this show, and that we all know are out there, the bills that drive people into debt, into bankruptcy…
All of that money, all of that suffering represents just 2.5% of what hospitals get paid for care, according to KFF data that Dollar For cites Two point five percent.
I don’t have a really deep insight here, but this number jolts me back to awareness of how big this health-care industrial complex is. And how much its dysfunction costs our whole society.
Like, zoom out. We spent five TRILLION dollars a year on this stuff — and so many people still don’t get the health care they need.
It reminds me that — along with understanding ways we can help ourselves and each other — individual, day-to-day ways — it’s important to understand why health care costs so freaking much. Where all that money goes, what we can maybe do about it.
Meanwhile, back to Jared and how he sees things going in 2026.
Jared Walker: Health care is going to get worse. Health care is going to be more unaffordable than it was. Health care is going to put more people into bankruptcy, more people into a bad financial situation.
Dan: Which makes the need for Dollar For’s work more obvious. Dollar For isn’t in danger of going away.
But all of the rapid change in the last year — the accomplishments and the setbacks — has Jared thinking hard about how to keep moving forward over the long haul.
Jared Walker: Dollar For has just been so scrappy. We’ve just been so scrappy, you know. I don’t want to be the, you know, the unpaid intern organization that’s just like, you know, burning everybody out. I want to be able to pay people well. I wanna be able to provide incredible healthcare benefits. I wanna be able to have a 401k match. Like, I want people to thrive at Dollar For.
Dan: That’s how you make sure people can stick around and keep growing, and figuring out how to make the biggest impact in a wild environment.
As we wound up our conversation, I wanted to tell Jared about how An Arm and a Leg’s 2025 had gone. Partly because I thought it might cheer him up a little bit.
So I told him about how a medical student named Thomas Sanford had put together a resource guide for patients based on our reporting, and started handing it out. How other listeners had been helping refine it.
How we’d put a version on our website — prompted by Thomas’s idea that health care workers could decorate the “badge reels” on their lanyards with a QR code patients could scan.
Jared Walker: Yeah. Putting it on the lanyard. I love it. And it is just something that we need more of is like, how do we empower the patient and the healthcare worker and the people that are, you know, up to fight it.
Dan: That’s it right there. The place we’re in right now — just with health care, the big picture can look really scary. Trying to take on the whole thing — heck, just trying to take in the whole thing, the big picture– it’s a lot.
And it doesn’t mean we stop trying. But we’re not individually responsible for fixing the whole thing right away. And we can find things to do — ways to help ourselves and each other IN THE MEANTIME.
Like by using the kinds of things we learn here to take a little more control over our own lives — and helping other people take control over theirs.
We spent a lot of the last couple of months asking you to help us keep doing our work– and you really came through. A lot of you included notes with your donations, incredible, heartening notes.
I’m gonna share one here — we actually shared it in the First Aid Kit newsletter last week — but I’m repeating it because it illustrates something:
“This amount, $85.23, is the amount I avoided paying because you taught me how to take notes when speaking to my insurance company, always getting the name of the representative and the call reference number.”
And here’s what I take from that: Every time any of us gets back a little capacity — saves a little money, saves some worry — from a system that threatens to overwhelm us…
That’s capacity we can put to use. To nourish ourselves and each other. To bank some new strength. And things that seem small — saving 85 dollars. Telling someone about Dollar For and helping them connect to charity care. There’s no way to know if they’ll add up to ENOUGH to move ourselves toward the structural change we need. But every bit truly does count.
So: Thank you again. For listening. For sharing what you know — I learned about Dollar For because listeners to this show saw Jared’s TikTok and made sure to tell me about it. And for doing what you can for yourself, and your family, and the people around you.
We’ll have a new episode for you in a few weeks.
Till then, take care of yourself.
This episode of An Arm and a Leg was produced me, Dan Weissmann, with help from Emily Pisacreta — and edited by Ellen Weiss.
Adam Raymonda is our audio wizard.
Our music is by Dave Weiner and Blue Dot Sessions.
Claire Davenport is our engagement producer.
Sarah Ballema is our Operations Manager. Bea Bosco is our consulting director of operations.
An Arm and a Leg is produced in partnership with KFF Health News. That’s a national newsroom producing in-depth journalism about health issues in America and a core program at KFF, an independent source of health policy research, polling, and journalism.
Zach Dyer is senior audio producer at KFF Health News. He’s editorial liaison to this show.
An Arm and a Leg is distributed by KUOW, Seattle’s NPR news station.
And thanks to the Institute for Nonprofit News for serving as our fiscal sponsor.
They allow us to accept tax-exempt donations. You can learn more about INN at INN.org.
Finally, thank you to everybody who supports this show financially.
You can join in any time at arm and a leg show, dot com, slash: support.
[Names redacted for web transcript.]
“An Arm and a Leg” is a co-production of KFF Health News and Public Road Productions.
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