North Carolina Governor Roy Cooper and the N.C. Department of Health and Human Services are pursuing a plan to alleviate $4 billion in medical debt, affecting about two million low and middle-income residents. Hospitals in the state can receive enhanced Medicaid funds by forgiving medical debt dating back to 2014 and offering discounts to patients. The initiative, awaiting approval from the U.S. Centers for Medicare and Medicaid Services, aims to address the significant issue of medical debt, especially impacting Black and Hispanic patients and rural communities. If all hospitals participate, up to $4 billion in medical debt could be relieved without requiring new state funds, potentially benefiting two million North Carolinians.