GOP Senator Roger Marshall Sued Over 700 Patients for Medical Debts as Low as $101 and 81 Ended Up Arrested

Republican Sen. Roger Marshall of Kansas and the obstetrics practice he owned sued more than 700 former patients over unpaid medical bills during his two decades as a physician, with 81 of those patients arrested after missing court dates, according to a New York Times analysis of Kansas court records that has become a flashpoint in his reelection campaign.

The lawsuits targeted debts as small as $101. Patients were routinely charged 18% annual interest, and some saw their wages or bank accounts garnished, according to the records.

Marshall, a former obstetrician-gynecologist who campaigns as "Doc Marshall," is seeking a second Senate term in November. His campaign has defended the collection practices as standard in the industry and has accused his Democratic opponent of distorting the record.

Hundreds of lawsuits over two decades

About half of the lawsuits were filed under Marshall's own name. The rest were brought by Heartland Regional OBGYN, the Great Bend practice he owned outright from 1998 to 2012 and co-owned until 2019.

Many of the patients lived in Barton County, a rural area with above-average rates of poverty and uninsured residents. Many were new mothers billed for labor and delivery, including some billed after a pregnancy loss or complications during childbirth. Others had insurance but still owed part of their costs.

Kellie Clutts was sued in 2015 over a bill of about $129 from a postpartum visit after her daughter's birth. Marshall sued her when her baby was 9 months old and eventually garnished her bank account.

"I had every intention to pay, I was just struggling," Clutts said.

Arrested while eight months pregnant

The case of Meischa Zimmerman has drawn particular attention. She was arrested three times over missed court dates tied to a $3,596 bill for a cesarean delivery.

Her first arrest came in 2011, when she was eight months pregnant and at home with her 2-year-old daughter. She has recalled asking officers not to handcuff her in front of the child.

Zimmerman said the bill went unpaid after she was unable to complete a Medicaid application. She later set up a $50 monthly payment plan but struggled to keep up as interest accumulated. She said she was told the debt had grown to more than $7,000.

Her final arrest came one week after Marshall won his first congressional election in 2016. Among the 81 cases in which records show an arrest, the underlying debts ranged from $114 to $4,683.

Who decided on arrests

Marshall's representatives have sought to distance him from the arrests. Marshall spokeswoman Payton Fuller said judges, not doctors, issue warrants when people repeatedly miss court dates.

However, court records show lawyers representing Marshall and his practice repeatedly requested arrest warrants.

Steven Johnson, an attorney who often represented Marshall in collection cases, said Marshall was not involved in decisions about when to seek warrants, arrests or garnishments. Johnson said Marshall did set the 18% interest rate, which was included in a contract patients signed.

Fuller said Marshall "spent decades caring for patients regardless of their ability to pay" and used the same billing and collection procedures as other Kansas businesses and hospitals. She also criticized the timing of the report.

"Sixty days before an election, the New York Times has decided that a rural doctor keeping the hospital's lights on is some kind of scandal," Fuller said. "Kansans know better."

How unusual is it?

Doctors have wide discretion over how to handle unpaid bills. They can choose when to send an account to collections, whether to sue, or whether to write off a debt when a patient appears unable to pay.

Barak Richman, co-director of the health law program at George Washington University, who has studied medical debt litigation in three states, said physicians vary widely in how they pursue unpaid balances. Neale Mahoney, an economist at Stanford University, said research in one state found lawsuits against patients were relatively uncommon, making the scale of Marshall's approach unusual.

Hospital ties and earnings

Marshall stopped practicing medicine after his election to the House in 2016, but some collection activity continued while he served in the House from 2017 to 2021.

He was also an investor in and board chairman of Great Bend Regional Medical Center, which he and eight other doctors opened in 1998 as a small surgery center before it grew into a full hospital. The hospital filed hundreds of lawsuits against patients during the years Marshall was involved, including more than a dozen filed while he was serving in Congress and before he sold his stake.

Fuller said the hospital provided millions of dollars in uncompensated care and followed the same outside collection procedures as other Kansas hospitals.

In 2015, his last full year delivering babies, Marshall earned about $780,000 from his obstetrics practice and the hospital combined.

A campaign issue in Kansas

The revelations have become central to Marshall's race against Democrat Adam Hamilton. The two clashed over the issue at the Kansas State Fair in Hutchinson, where Hamilton criticized Marshall's litigation practices and his votes in Congress against expanding health coverage.

The Hamilton campaign has since aired an ad featuring Zimmerman. Marshall's lawyers responded with a cease-and-desist letter calling the ad defamatory. They argued Zimmerman was arrested for failing to appear in court, not for a missed payment, and that the ad wrongly framed the arrest around a $50 bill rather than her total debt.

The letter said falsely accusing a physician of having a pregnant patient arrested over a $50 bill "strikes directly at Senator Marshall's professional integrity."

Hamilton campaign spokesperson Tyson Brody said Marshall had never disputed Zimmerman's account that his lawyers had her arrested in front of her children.

"The lies in his letter are blatant and reek of desperation," Brody said.

Marshall's campaign has countered that Hamilton is misrepresenting the senator's record, noting that a Democrat has not won a U.S. Senate seat in Kansas in nearly 100 years.

Broader debate over medical debt

The controversy comes amid a national debate over medical debt, which affects an estimated 1 in 3 Americans. Some states have moved to limit aggressive collection practices, including caps on interest rates for medical debt and bans on wage garnishment and liens on primary homes.

For patients like Zimmerman and Clutts, those changes came too late. Their cases, buried for years in rural Kansas court files, are now at the center of one of the most closely watched Senate races heading into the November election.