Over 900 debt collection lawsuits have reportedly been filed against patients for more than $17.8 million in unpaid medical bills in 62 Texas counties since Republican Texas Governor Greg Abbott declared a state of disaster in mid-March.

“I’d say, fast forward a year from now, regrettably or not, we’ll see a ton of bankruptcy,” Dana Karni, an attorney for Lone Star Legal Aid, told the Texas Tribune. Citing a lack of income combined with increased bills, Karni said she doesn’t “see how consumers can come out from all the debt.”

Out of 414 investigated Texas hospitals, 28 reportedly filed suit against patients for unpaid medical bills between 2018 and 2020 according to a study titled “Eroding the Public Trust” conducted by the Health Care Research and Policy Team at Johns Hopkins University.

Almost half of the total number of suits were filed against low-income families, The Dallas Morning News reported Wednesday. The lawsuits mostly recovered “negligible portions of each medical facility’s revenue,” but they financially crippled some patients through “seizing indebted patients’ property after winning their suits,” according to the Tribune.

“I’ll be paying until I die.” https://t.co/6fuEfg9FBG

— Texas Tribune (@TexasTribune) May 27, 2020

Patrick Easley is a 62-year-old civil engineering construction inspector outside of Houston who told the Texas Tribune he has not had access to health insurance since being laid off during the 2009 recession.

“Premiums and medical costs have become too expensive since the Affordable Care Act was passed,” Easley told the Texas Tribune.

Easley hired a lawyer to attempt to negotiate the amount he owed after being ordered to pay $16,196.02 in medical debt to a Tomball hospital that had treated his wife for chronic obstructive pulmonary disease, the Texas Tribune reported. The debt had a 5.5% interest rate and a $3,000 attorney fee.

“Either pay up or they’ll put a lien against [all your assets] … I was like, ‘I’m against a wall. I’ve got to do what I’ve got to do,'” Easley told the Texas Tribune. He agreed to pay what he could, about $125 each month.

“I’ll be paying until I die,” he said.

The Johns Hopkins team found that hospitals sued for more than $17.8 million in total medical debts and reported that the average lawsuit was somewhere between $4,000 to $40,000 on average, according to the Texas Tribune. The patients hit with lawsuits lived mostly in counties where the median household income was below the national average, according to the same source.

In roughly half of the cases, Johns Hopkins reportedly found that patients did not appear in court, allowing the medical facility a default victory.

Texas hospitals that received bailouts are suing poor patients for failing to pay medical bills https://t.co/Bd3N55A18w

— Houston Chronicle (@HoustonChron) May 27, 2020

Cedar Park Regional Medical Center of Williamson County and Longview Regional Medical Center of Gregg County both filed 84 cases against patients from 2018 to 2020, according to the Texas Tribune. The South Texas Regional Medical Center filed the highest number, with 109 cases total.

“It is our strong preference not to take legal action and to work directly with patients regarding what they owe for healthcare services that have been provided,” CEO of Cedar Park Regional Medical Center Bo Beaudry said in a statement released May 26. “Litigation is always a last resort and is only pursued after we determine the patient has the financial ability to make some level of payment based on employment status and credit record.”

Both statements from Cedar Park Regional and Longview Regional specifically said they attempted to contact patients with outstanding debts at least 10 times or more to arrange a method of payment. Both medical centers claim that legal action is a last-resort measure.

Longview Regional went on to say that litigation is “only considered after evaluating the patient’s credit record and verifying their employment status.” Cedar Park Regional said legal action was, on their part, only pursued after determining “the patient has the financial ability to make some level of payment based on employment status and credit record.”

District clerk’s offices confirmed that lawsuits over medical debt have recently been filed, but some other proceedings have been paused such as default judgements which result in a win for medical facilities if patients don’t respond, the Texas Tribune reported.

However, debt collections have been approved to resume later this month in a decision made by the Texas Supreme Court.