Following the lead of some other local governments, New York City has pledged to pay down $2 billion worth of residents' medical debt. The idea emerged a couple of years ago in Cook County, Ill., when two staffers suggested spending part of its federal pandemic rescue funds to relieve residents' medical debt. In 2022, Cook County became the first local government to partner with RIP Medical Debt, which uses private donor funds to buy up and pay off health care debts, spending $12 million to retire $1 billion worth of hospital bills for residents. Seven other local governments have followed suit, including Akron, Cleveland and Toledo, Ohio, New Orleans, Wayne County, Mich., Washington, D.C., and now New York City, and RIP is talking with 30 more municipalities and states. Medical debt affects an estimated 100 million people in the US.