Medical debt lawsuits across Minnesota have surged to the highest level in five years, according to a new analysis by independent nonprofit Pew.

When patients are unable to pay their medical bills and fall into debt, hospitals and health care providers often turn over that debt to collection agencies, and eventually, they can be sued by the provider or a collection firm for payment.

Lester Bird, a senior manager with Pew Charitable Trusts, said those lawsuits can come with financial repercussions, such as having your wages garnished, and they can also have emotional consequences.

“The impact of having to go to court is huge, right?” he said. “People are scared that they might get arrested or go to jail for these unpaid debts. It’s not true for the most part, but you know, this is the sort of fear people have.”

Minnesota has some protections in place, especially for low-income patients. In October, the Minnesota Debt Fairness Act took effect. It bans reporting medical debt to credit bureaus, prohibits denying necessary medical care to patients because of unpaid bills, and limits wage garnishment of low-income workers, among other reforms. But Bird said Minnesota courts could do more to weed out invalid cases brought against patients.

The Pew analysis, based on data from consulting group January Advisors and the National Center for State Courts, found that the number of medical debt lawsuits filed in Minnesota dropped significantly during the pandemic, but they have now surged back to pre-pandemic levels.

Lawsuits filed for overall consumer debt, including debt from unpaid medical bills, auto loans and credit cards, are also increasing — not just in Minnesota, but across the country. Some experts say these cases are possibly aided by artificial intelligence, which makes it easier for companies to analyze debt that is piling up and file lawsuits quickly.

David McClendon, a senior partner and consultant at January Advisors, said that medical debt cases are likely going up because hospital budgets are tightening, and because patients are no longer receiving pandemic stimulus payments that kept many of them afloat and out of debt in recent years. Hospitals may have also been trying to avoid bad optics when COVID-19 was spreading.

“Suing people during a pandemic was not a good look for a lot of hospitals,” McClendon said.

McClendon said the University of Minnesota’s Fairview Health Services is currently leading the increase in Minnesota, filing more than 4,000 medical debt lawsuits against patients with unpaid bills in 2024. He said Fairview is not only the biggest filer, it’s also increasing its case numbers at the fastest rate.

A Fairview spokesperson told MPR News that litigation is only pursued in rare circumstances — roughly 1% of their clinical bill — and never against patients who have a clear inability to pay.

“We exhaust every possible option to support patients long before considering legal action,” the spokesperson said. “We also believe it’s important to recognize the broader forces driving patient medical debt. While hospitals are often the focus of scrutiny, many of the underlying challenges stem from payer practices — including high-deductible plans, denied or delayed claims and insufficient reimbursement rates — that leave patients caught in the middle.”

Mayo Clinic and Allina Health systems both received flak in recent years for suing patients over medical debt. McClendon said he doesn’t have any records of Mayo Clinic suing patients since 2023, and Allina Health’s lawsuits have gone down significantly since the negative media coverage.

McClendon said one of the biggest hurdles is that patients might not even know to go to court when they’re sued. Sometimes the notice doesn’t get to them, as it is sent to the wrong address, or they assume it’s spam because the letter came from a third-party debt collector they’ve never heard of. And even if they want to fight the charge, McClendon said the hundred or so dollars it can cost in legal fees can be prohibitive.

“Most of these cases are for $1,200, $1,500. If people don’t have $1,200 or $1,500, they don’t have 200 or so dollars to be able to participate in the case in the first place. And so then what happens is that leads to people’s wages being garnished and keeps people in this sort of cycle of poverty,” he said.

Bird said that as the number of these lawsuits increases, this is an urgent moment for legislators, policymakers and court leaders to take action.

He said he wants courts to act as more of a back stop and confirm that the right person is being sued by the right company for the right amount before proceeding.

Bird’s research indicates that many of these cases are inaccurate or missing crucial documents, and shouldn’t even be treated as valid. He also wants to make it easier for patients to defend themselves. Minnesota is a step ahead in this regard since it already requires that patients who successfully defend their lawsuit be compensated for any attorney fees incurred.

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Even though it’s intimidating, Bird said he recommends patients go to court when they’re sued. They might be able to finagle a discount or a payment plan if they participate.

“These companies do negotiate with people,” he said, referring to the hospital or third-party debt collector. “There are fees that can be waived, but it requires a person to show up and engage in the lawsuit.”

MINNEAPOLIS (AP) — A funeral was held Sunday for an 8-year-old boy with an infectious smile and adventurous spirit who was one of two schoolchildren killed when a mass shooter opened fire on a Minneapolis Catholic church during Mass.

Hundreds of mourners gathered for the service of Fletcher Merkel, wearing bright colors instead of somber black at the request of his family. He had boundless energy and exuded generosity, handing out flowers and trading cards just because, said his aunt, Erin Shermak, the Minnesota Star Tribune reported.

“His gift to us was the chance to know him and love him,” she said.

The Aug. 27 shooting injured at least 21 others, most of them students at Annunciation Catholic School. Officials have identified the shooter as Robin Westman, 23, a former student armed with a rifle, pistol and shotgun who allegedly fired more than a hundred rounds through the windows of the church just before 8:30 a.m. Westman was found dead of what appeared to be a self-inflicted gunshot.

A service for Harper Moyski, the 10-year-old girl who was also killed in the shooting, will be held Sept. 14 in Minneapolis. An obituary described the girl as “pure magic,” a dog lover who dreamed of becoming a veterinarian one day.

Speakers at Mount Olivet Lutheran Church on Sunday choked back tears to smile and laugh in honor of Fletcher’s brief life. They held funeral programs featuring his portrait, with the words: “Forever loved, child of God.”

Mourners talked about his love of fishing, something he often did with his dad Jesse, and how he made friends wherever he went.

Fletcher was “always in motion,” a child who loved playing sports and trying out new foods, like pickled herring, according to his obituary.

He was recently and briefly on-air at a local radio station when his mother Mollie called in so Fletcher and other children could give their best impression of fireworks for a contest.

Besides his parents, he leaves behind two brothers and a sister and his dog, Clementine.

Mourners included Minneapolis Police Chief Brian O’Hara, St. Paul Mayor Melvin Carter and Gov. Tim Walz and his wife Gwen.

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KANSAS CITY, Mo. — Byron Buxton said he would be OK after getting hit by a pitch on his left knee and exiting early in the Twins’ 5-1 victory against the Kansas City Royals on Sunday.

Buxton, who led off the game with his 30th home run, went down to the ground for a few moments after right-hander Michael Lorenzen hit him with a 92 mph sinker in the fifth inning. Buxton stayed in the game to run the bases, and he returned to center field for the bottom of the fifth and the sixth. By the seventh, the pain was telling him to cut it short.

But he sounded optimistic that he’d be ready to play Monday at Anaheim against the Los Angeles Angels.

“It got me good enough to come out,” Buxton said. “I tried to fight a little bit through it, but just trying to be smart and make sure I’m ready for tomorrow.”

Happy to have the Twins break a six-game losing streak, Buxton also was excited to realize that his long ball made him the franchise’s second player to reach at least 30 homers and 20 steals in the same season since Kirby Puckett in 1986. Buxton needs nine stolen bases for 30 and has 19 games to get there.

“I don’t even know what to say to that,” Buxton said. “Obviously Kirby was a big icon here, so to be in a club like that with him is… I’ll think on that. It’s special.”

Buxton’s homer also tied him with Tom Brunansky for 10th all-time on the Twins career homer list with 163. Brian Dozier is ninth at 167.

Kody Clemens later added a two-run homer that went an estimated 451 feet to center. “An absolute bomb,” manager Rocco Baldelli said, “that gave us some separation.”

Ober achiever

Right-hander Bailey Ober made his best start in a month, and picked up a win for the first time since May 3 by allowing a run, four hits and a walk to go with six strikeouts over 5 1/3 innings. Ober said the individual win meant little to him, but pitching well enough for the Twins to win was huge.

Ober (4-8) did the work mostly by bypassing his fastball, which was still registering below his season average velocity and his velo from 2024. Ober came in with a 5.23 ERA.

“I wouldn’t say it was intentional,” Ober said. “It was just kind of seeing what they were on and what they weren’t. I felt like I was able to mix and locate my off-speed, whether that was changeups or the hard slider or the sweeper. So I felt like I had that rolling, and they weren’t adjusting as early as I thought they might be.”

Jeffers put on concussion IL

Catcher Ryan Jeffers just didn’t progress fast enough for the Twins to avoid putting him on the concussion IL. He took two foul tips off his headgear Thursday against the White Sox in Chicago, and missed the Royals series entirely, though the Twins played with a short roster the first two games in Kansas City while they evaluated Jeffers reactions.

The move was retroactive two days to Friday. Jeffers traveled Sunday morning back to the Twin Cities. Carson McCusker and Pierson Ohl were added from Triple-A St. Paul, and right-hander Brooks Kriske was designated for assignment or release.

Twins trainer Nick Paparesta said Jeffers appeared to be improving early Saturday, but some symptoms — like feeling groggy — didn’t disappear late in the day.

“His symptoms [at first] were basically like fogginess, just kind of out of it,” Paparesta said. “He felt difficulty processing and just struggling to be his normal self. The first day we got to Kansas City, those symptoms remained. He did look better Saturday… but as the day went along, those symptoms never went away. They were still there and present.”

Paparesta said it was his understanding that Jeffers never had a concussion as a major leaguer before.

Topa startled by knee pain

Trying to close out the game, right-hander Justin Topa made a pitch in the ninth inning and felt a pain in his knee similar to the patellar tendon injury that ruined most of his 2024 season. He left the game and a save opportunity to Génesis Cabrera, who closed out the Royals with Mike Yastrzemski as the tying run at the plate.

After getting with the medical staff, Topa doubts the knee injury is too serious.

“I kinda had just like a zinger,” Topa said. “Felt it in the patella tendon. Literally the first time I felt anything there all year. So that’s why I was a little taken aback.”

Topa missed most of the 2024 season in part because of a knee injury he sustained in Spring Training. This is not that, even if it frightened him for a bit.

“Obviously, with the history last year and everything that was going on, we just said to take a look at it,” said Topa, who picked up a hold with his scoreless inning-plus, lowering his ERA to 3.90.

“Doctor said that structurally, everything looks good,” Topa said. “He just kind of pressed around almost trying to make it feel that way again and it didn’t, which is good.”

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St. Paul homeowners can expect one of the largest property tax increases in recent memory next year, and the city’s poorest neighborhoods will be hit especially hard.

The market values of residential properties in Ramsey County are up nearly 5% over last year, while apartments and commercial buildings are down about 2-3% and agricultural land is down nearly 17%.

Those changing values mean homeowners must cover a greater share of the property tax burden at a time when the city, county and school district are planning big increases to their tax levies. Meanwhile, about $1 out of every $7 of market value in the city is a property that doesn’t pay taxes, such as a college, government building, church or other nonprofit.

“Declining commercial and apartment values are shifting the property tax burden to residential taxpayers,” County Auditor Tracy West told the County Board of Commissioners recently, “and exempt properties do not generate tax and make up 14% of the county’s market value.”

The Ramsey County Board of Commissioners has discussed raising its property tax levy by 9.75%, and St. Paul Mayor Melvin Carter wants a 5.3% increase for the city.

St. Paul Public Schools will release its tax plan in the coming weeks, but whatever they do will be in addition to a ballot referendum that asks voters to pay another $37.2 million per year for 10 years.

Neighborhood differences

Each year, Ramsey County’s tax office details the cost increases facing the owners of median homes in suburban cities and St. Paul neighborhoods. So far, their analysis is limited to the cost of just the county’s own 9.75% increase.

According to a Tuesday presentation to the Board of Commissioners, St. Paul home values are rising fastest in the most affordable neighborhoods, which means they’ll see the largest tax increases, at least as a percentage of what they’re paying.

The county levy alone will cost the median Frogtown homeowner another $228, or 7.3%, with similar impacts in Payne/Phalen, the North End and West Side.

Como, Hamline-Midway, Dayton’s Bluff and Summit/University homeowners won’t pay quite that much.

And Sunray/Battle Creek/Highwood and St. Anthony Park will see some of the lowest tax hikes in the city, while downtown owners may even see a decrease.

The picture throughout the rest of the county is more mixed. The wealthiest city, North Oaks, has seen a county-high 7.6% increase in its property values, which means about a $900 increase in what the median home pays for the county levy. On the low end, the typical North St. Paul home will pay just $62 more.

The actual tax increases for homeowners will be much greater than the county analysis shows, as Ramsey County’s levy accounts for just 35% of what property owners pay in property taxes.

Levy plans announced so far — including the city, county and school referendum, but not the regular St. Paul Public Schools levy or smaller taxing authorities — will cost the median St. Paul resident an additional $620 next year.

The county will add the St. Paul levy to its analysis next week and will incorporate other taxing jurisdictions once final numbers are certified Sept. 30.

Falling commercial values

The slide of commercial values is nothing new, and some of the steepest have been in downtown St. Paul. The U.S. Bank Center on 5th Street has seen its estimated market value slide from $21.7 million in 2024 to $20 million this year, and down to an estimated $14 million for the purpose of calculating taxes in 2026.

Corresponding property taxes for U.S. Bank Center will have fallen precipitously from $729,000 last year to an estimated $495,000 next year.

Downtown St. Paul commercial properties have lost about 11% of their value from one year to the next, compared to almost 2% in Ramsey County’s commercial properties as a whole.

The 3M headquarters on McKnight Road in Maplewood carried an estimated market value of $98 million in 2024, which fell to $93.6 million over the past year, according to the county. That value will fall to $89.8 million next year.

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Acorn Mini-Storage on Cleveland Avenue in Roseville — formerly a HOM Furniture store — has seen its estimated market value drop from $7.43 million to $6.7 million in two years.

While apartment values in the county have dropped another 3%, according to County Assessor Pat Chapman, “We’re finally getting to a place where the market has enough units to make values level off.”