A Broken Arm, A Broken System

When Deborah Buttgereit slipped on the ice outside her Montana apartment, she knew she couldn’t avoid the hospital. What she didn’t expect was the bill—nearly $98,000.

Deborah shared her cautionary story with KFF Health News. After her husband’s sudden death, she struggled to afford health insurance coverage. She was briefly enrolled in a subsidized plan, but when her part-time income pushed her just over the assistance threshold, she had to drop it. She was uninsured.

Two months later, she fell.

The hospital initially estimated her surgery would cost about $50,000. But mid-procedure, doctors found her bone was shattered in more places than expected and the final bill nearly doubled. Even after a self-pay discount, Deborah owed more than $78,000.

She fought back. She called the hospital, questioned the charges and asked about protections under the federal No Surprises Act. She was first told the law didn’t apply. She later learned she could dispute the bill, but only after the hospital gave her the wrong filing deadline.

Deborah isn’t alone. Patients across the country are blindsided by bills that far exceed estimates. While hospitals point to complications and rising costs, patients are left with impossible choices: accept financial aid that still validates inflated charges, or spend years contesting bills they may never be able to pay.

Consumer advocates say uninsured patients have some recourse. The No Surprises Act created a dispute process when a final bill is at least $400 higher than the estimate. But few people know about it, and hospitals don’t always make it easy to navigate. A consumer toolkit is available to help patients push back and assert their rights.

Deborah’s story is a stark reminder that in America, one slip on the ice can lead not only to a broken arm but to a lifetime of medical debt.

What do you think? Have you gotten a surprise medical bill that felt impossible to fight? Share your story at Voices for Affordable Health.