Orange County commissioners on Tuesday approved additional funding for a first-of-its-kind program in Central Florida to eliminate medical debt for local residents.
Since 2024, the county has leveraged $4.5 million in federal dollars received under the American Rescue Plan Act to eliminate over $637 million in medical debt — one of the leading causes of bankruptcy — for more than 427,000 Orange County residents.
A recent study published by the Urban Institute found that nearly half (46 percent) of U.S. adults aged 18 to 64 struggled to afford healthcare in 2025, including adults with and without health insurance.
The debt relief was made possible through a partnership with Undue Medical Debt, a nonprofit organization based in New York that has partnered with more than two dozen local and state governments nationwide to relieve medical debt.
Orange County is the first and only municipality in Florida that’s entered into a partnership with the organization (formerly known as RIP Medical Debt) to help relieve this burden on locals. Other non-government organizations in Florida, however — like the Tampa chapter of the Democratic Socialists of America — have similarly worked with Undue to eliminate medical debt weighing down cost-burdened residents in their communities.
“Orange County is preparing for its fourth wave of what has become the largest medical debt relief initiative in Central Florida’s history,” Orange County commissioner and vice-mayor Kelly Martinez Semrad shared Tuesday during a county commission meeting. Martinez Semrad led the meeting as Orange County Mayor Jerry Demings, who was recently diagnosed with prostate cancer, recovers from surgery.
A fourth wave of debt cancellation
Orange County announced its first wave of $472.5 million in medical debt cancellation in May 2025. Another $42.9 million in relief was announced last October, and in April, the county announced an additional $43 million in debt relief on top of that, bringing total debt relief to $559 million. According to Undue, the average debt relief cancellation in Orange County is $1,620.
“At a time when families across Florida, and the country, face growing uncertainty about access to care, Mayor Demings and the Orange County Board of County Commissioners are demonstrating bold, community-minded leadership,” Allison Sesso, president and CEO of Undue Medical Debt, said in a statement this past April. “We’re proud to continue this partnership and hope this relief encourages recipients to reengage with the healthcare system without fear of the cost.”
How medical debt relief works
Eligible recipients of the medical debt relief initiative include individuals with a household income at or below 400 percent of the federal poverty line — equal to $63,840 for a single-person household — or residents whose medical debt exceeds 5 percent of their total household income.
Undue’s process of abolishing debt works by identifying and collecting medical debt held by debt collection agencies or local hospital systems, and canceling it for essentially pennies on the dollar. A single dollar invested by the nonprofit, on average, can erase $100 in medical debt, according to Undue.
Within the Orange County program, Undue uses the county’s funding to purchase debt acquired by eligible Orange County residents only. There is no action required by the beneficiaries, nor any application process. Notices of debt cancellation signed by Undue Debt Relief are mailed to beneficiaries after the debt is erased.
Orange County’s investment in the medical debt relief cancellation initiative originally stemmed from a campaign organized in 2023 by Central Florida Jobs With Justice, a coalition of labor, faith, community and student groups.
An added investment
County commissioners this Tuesday agreed to allocate an additional $2 million for the debt relief program, bringing the county’s total allocation since 2024 to $6.5 million. The extra $2 million is expected to abolish approximately $200 million in additional medical debt, impacting as many as 100,000 Orange County residents, according to Orange County’s Community and Family Services department.
All of the funding for the program comes from the Biden administration’s American Rescue Plan Act of 2021, a federal stimulus package that distributed billions of dollars in emergency funding to local and state governments during the COVID-19 pandemic.
All of that funding has to be spent by December 2026, a Community and Family Services spokesperson confirmed. The added $2 million for the county’s debt relief program is unused “surplus” from the county’s total allocation of roughly $270 million, they added. The rest of the county’s ARPA funds were allocated for business assistance, health and public safety, infrastructure projects, social and community services, and revenue recovery, according to county documents.
