SAC Review #54 – Fall 2025 Edition

FALL 2025 – #54

QUARTERLY NEWSLETTER

US Healthcare Crisis:

Mother Dies After Insurance Denies Life-Saving Drugs

By Joy Stephenson-Laws, Managing Partner Introduction: A Heart That Couldn’t Wait Kierra Campbell was 27 years old. A mother of seven.

A fighter battling end-stage heart failure. She didn’t lose her life solely to illness; she lost it to an unforgiving bureaucracy that let paperwork outweigh the value of her life. Her heart medication was cut off because of a missed child support hearing that triggered a sanction, ending her Medicaid coverage.

The IV drugs keeping her alive cost $1,000 a week.

Without insurance, Kierra couldn’t pay. And without those drugs, her heart couldn’t keep beating.

Her last words, recorded in a heartbreaking message, ring like an alarm bell: “It’s over for me y’all. They’re stopping my medicine and everything… they set me up for the end stage of my life. Three months or less is what they gave me.” Her final plea, shared through a GoFundMe campaign, asked for just three more weeks of medication. Enough time, she hoped, to resolve the insurance paperwork and get back to her kids.

That time never came.

Here’s how quickly a life can unravel: Kierra had been hospitalized for over a month with severe heart failure. During that time, she missed a child support hearing. The court issued a sanction. Medicaid was terminated. The hospital’s pharmacy flagged her account. Her IV medications stopped. Within weeks, she was recording her final message. The entire sequence—from missed hearing to death sentence— took less time than most insurance appeals.

Kierra required continuous IV medications—likely milrinone or dobutamine—drugs that help failing

QUARTERLY NEWSLETTER hearts pump blood. These aren’t pills you can pick up at a pharmacy. They require specialized infusion pumps and monitoring. For someone with 10% heart function, they’re not optional. They’re life support.

In Kierra’s case, a missed child support hearing triggered a sanction that cut off her insurance. The irony is cruel: the same system holding her accountable as a parent left her children motherless.

GoFundMe as Healthcare: A National Crisis

This isn’t just Kierra’s story. It’s the story of a system that routinely fails the most vulnerable. Especially Black women. Especially poor mothers. Especially those already fighting for their lives.

The Cost of Delay: Bureaucracy and Burden

Her campaign asked for $3,000—three weeks of medication. The heartbreaking reality is that medical expenses have become the largest category of GoFundMe campaigns. It’s the digital equivalent of passing the hat.

When Healthcare Becomes a Luxury Kierra’s case is shocking, but not unique. Across the United States, people are dying because they cannot afford their medications. A missed deadline, a rejected form, a bureaucratic delay—any of these can strip someone of their lifeline.

The connection between child support and Medicaid varies by state, but many states can suspend benefits for “non-compliance” with court orders. Missing a hearing—even while hospitalized—can trigger automatic sanctions. It’s a system that punishes poverty with more poverty, and in Kierra’s case, with death.

Take Cole Schmidtknecht, a 22-year-old from Wisconsin. He died of a severe asthma attack after his corticosteroid inhaler—a medicine he had used for years—jumped from $66 to over $500. The insurer changed its formulary without notifying him or offering affordable alternatives. Cole left the pharmacy empty-handed. Five days later, he was dead (People, 2024).

Or consider Nataline Sarkisyan, a 17-year-old with leukemia. She was denied a liver transplant by Cigna because it was deemed “experimental.” After public outrage, the insurer reversed course—but too late. Nataline died hours after approval (Wikipedia, 2024).

These stories share a haunting thread: lives hanging in the balance, pushed over the edge by price tags and policies.

Who Is Most at Risk?

According to the Kaiser Family Foundation, Medicaid is a critical safety net for nearly 94 million Americans (KFF, 2023). Yet it is a system plagued by red tape and administrative burdens. For low-income people—especially single mothers—even a minor disruption can be fatal.

And the data is even more alarming for Black women.

B lack women are three to four times more likely to die from pregnancy-related causes than white women (CDC, 2022).

T hey are less likely to be believed by healthcare providers when they report pain or symptoms (Hoffman et al., 2016).

T hey are overrepresented in low-wage, uninsured, or underinsured jobs, which often lack paid time off for court hearings or medical appointments (National Women’s Law Center, 2023).

Even short-term lapses in coverage can have catastrophic outcomes. A study published in Health Affairs found that people who lost Medicaid for just one month were significantly more likely to skip needed care, be hospitalized, or suffer health declines (Sommers et al., 2016).

This phenomenon is called “churn”—the cycle of gaining, losing, and regaining Medicaid coverage.

Often caused by administrative snafus like income verification or missed notices, churn disproportionately affects people with chronic conditions.

Kierra had been hospitalized for over a month at The Christ Hospital in Cincinnati. Her heart function had dropped to just 10%. She couldn’t be discharged without her medication. But with her insurance canceled, the hospital couldn’t keep supplying the $1,000/week drugs. The system halted her care mid-crisis, effectively sentencing her to death.

Hospitals have patient assistance programs, but they’re often limited to short-term help or require lengthy applications. The Christ Hospital, like many facilities, was caught between providing uncompensated care indefinitely or discharging a patient to certain death. The real failure isn’t the hospital’s—it’s a system that forces such choices.

A Healthcare System Built to Exclude In the U.S., access to healthcare is often tied to employment, marital status, or legal compliance.

This design systematically disadvantages people already in crisis. Miss a court date? Lose your insurance. Lose your insurance? Lose your meds. Lose your meds? Lose your life.

Compare this to other high-income countries with universal healthcare systems. In other developed nations, Kierra’s story would be impossible: UK: The NHS provides all essential medications free at point of care for those with chronic conditions Canada: Provincial health plans cover life-sustaining medications, with additional support for low-income patients Germany: Mandatory health insurance covers all critical treatments with minimal co-pays (capped at 2% of annual income) France: 100% coverage for long-term illnesses including heart failure These aren’t perfect systems, but they share a principle: no one dies because they can’t afford medication.

Kierra’s last hope was not her doctor or her hospital or her elected officials. It was GoFundMe.

But relying on crowdfunding to save lives is dangerous and inequitable. Success depends on visibility, social media reach, and the public’s willingness to be moved by your story. Kierra shouldn’t have had to tell the world she was dying just to get a shot at surviving.

How We Fix This: Policy and Prevention

The tragic loss of Kierra Campbell demands more than mourning. It calls for systemic change. Here are actionable steps to prevent another needless death:

1 Automatic Grace Periods for Medicaid Sanctions: States must implement a 30- to 90-day grace period before terminating life-saving benefits due to court-related sanctions or missing paperwork.

2 N otification and Alternatives When Medication Prices Rise: Pharmacies and insurers should be required to notify patients in advance of drastic price increases and offer affordable therapeutic alternatives.

3 Medicaid Portability and Court Accommodation: Individuals involved in family court or support hearings should receive automatic Medicaid protections. Legal and medical systems must communicate.

4 Universal Coverage for Essential Drugs: Congress must pass legislation that guarantees access to essential medications (like heart failure IV meds or asthma inhalers), regardless of insurance status.

5 National Patient Advocacy Corps: Create a network of publicly funded patient advocates to help people navigate bureaucratic hurdles before they lose coverage or medication access.

Say Her Name: Kierra Campbell

Kierra tried. She fought. She didn’t ask for pity. She asked for time. For three more weeks. For a chance to live. Her children now live with the permanent silence of a mother who should still be here.

Her death is a policy failure, a moral failure, and a national failure.

But it doesn’t have to be the last one.

When we say her name—Kierra Campbell—we commit not just to remember her, but to change the system that abandoned her.

FALL 2025 – #54

Seven Children, One Question: What Now?

court while dying has no mechanism to restore what it took from them.

Kierra’s seven children—the very ones the child support system claimed to protect—are now motherless. They’ve joined the ranks of children orphaned not by accident or crime, but by policy. Extended family, already stretched thin, must now fill the gap.

The system that demanded their mother appear in

What You Can Do

Most of my cases involve assisting clients throughout California but I also help clients across the country in D.C., Maryland, Nevada, Oregon and Washington.

My family extends throughout California and across the country and when I can help a provider recover I know that will impact the community of my friends and family, and I get an extra sense of pride in my work. Most of my work consists of managed care and commercial insurance disputes in arbitration.

However, I am proud to say that when uncontracted claims become an issue, I am happy to take payors to court and help recover on claims at the state or federal levels

What one piece of sage advice can you offer to our clients that can help them in the future?

Each claim should be documented like you are potentially presenting it to someone who has no idea what occurred during the course of treatment. An arbitrator or judge is exactly in that position. Cases need every piece of documentation and detail to be tracked so we can present and prove exactly what happened.

Most of the time, if something was not documented, for purposes of supporting the claim, it did not happen. It makes justification of a charge or course of treatment difficult. In many cases, I am presenting opposing counsel with documents they should have gotten from their own clients. It’s also great to present the receipts for letters and transactions between the parties when the other side insists that it never occurred. It is always better to have a document and not need it, then want a document and not have it.

Can you talk about a recent success story of yours? What was the challenge and how were you able to overcome it?

Effective file handling includes seizing resolution opportunities at the earliest appropriate time. This

Speak out when you see injustice. Amplify the voices of those forced to fundraise for survival.

Donate to medical GoFundMe campaigns, but also ask why they’re necessary.

This isn’t just a matter of policy. It’s a matter of life.

Call your state Medicaid office and urge policies that protect against sudden coverage loss.

Say her name.

And make it mean something.

Attorney, Alex De Arana-Lemich.

What is your area of expertise within SAC?

Support organizations like Families USA and the National Health Law Program that fight for healthcare access.

often includes a strategic approach to claim review efficiencies that can take a case with a large inventory of claims and reduce to manageable number for resolution. Recently, we had three cases between the same hospital system and the same payor with claims exceeding 630. The amount underpaid totaled multiple millions and were schedule to be resolved via arbitration through the end of 2027. We persuaded the payer to discuss resolving all claims at once through mediation. We targeted the top 60 claims, representing the lion’s share of the value in the case. Our medical review team, equipped and the necessary resources to efficiently complete their reviews, were able to provide solid support to maximize the strength of the claims.

Ultimately, we reached a multimillion-dollar settlement and were able to preserve the ability to pursue claims against other payors. We were not only able to mitigate the costs of all litigation, but we were able to settle these claims two years early and ensure that the funding made it to the provider much sooner, ultimately delivering a greater value to the client.

Do you have any hobbies or interests outside of work?

My hobbies include traveling, wine tasting, and indulging my multifaceted nerdom including Star Wars, Star Trek, Harry Potter and other lesser known fandoms. I love exploring my European roots through traveling to my many ancestral homelands or devouring books that help me learn a little more of my family’s origins.

Do you have any charitable causes that interest you and events you have participated in recently?

As an attorney who focuses on revenue cycle issues, I have taken a greater interest in the actions of HFMA and AAHAM. Last month I went to the ANI event in Maryland where not only did I get to increase my knowledge in the space, but I got exchange ideas with providers from across the nation and find

common ground and new ways to face issues that are common to many of my clients. I also recently attended a Think Tank for providers through HFMA at Cottage Hospital where providers worked to discuss how to tackle issues affecting each facility and how the opportunities and challenges of automation and AI can help bridge that divide We are all members of a team, and I do my best to show that I am ready and willing to roll up my sleeves to find answers together.

Do you have family and/or pets you’d like to tell us about?

Between the hustle and bustle of life, I have learned that the time with family is often too rare and fleeting. My wife and I also each have large families and extended families adding miles to our travels to keep up the connections.

When I am not in the courtroom or with my nose in a book, I love spending my weekends taking my young daughter to a new park, going to community events, or watching the sea lions bark in the harbor.

I also have a labrador named Penny that keeps me busy with adventures through parks and down the beaches of my hometown.

Do you have any guilty pleasure television shows, movies or other activities to tell us about?

I am not a baker or a great cook, but I love watching the Great British Bake Off with my wife. It’s a wholesome and tantalizing way to spend evenings. I also love to be active in the development of my community. I honestly find it fun to attend a local HOA, city council or public agency meeting.

What are your favorite foods?

Colors? Other favorites?

I love Thai and Indian Cuisines or a great steak when my wife and I find the time to hit the town. Forever one of my favorite dishes is my mother’s meatloaf, mashed potatoes and peas. The only dish that could step in for Thanksgiving if needed and the dish that we also attribute to the arrival of my daughter a few days early.

I am a Dr. Pepper fan and have even called the company to offer an idea for a new product line and only requested a free six pack as compensation if they ran with it. No indications they took me up on the idea or the offer.

UPCOMING EVENTS:

HFMA Western Region Symposium 2026 SAC is proud to be a sponsor of the 2026 HFMA Western Region Symposium, taking place January 18–21, 2026 at Paris Las Vegas Hotel & Casino. This annual gathering brings together healthcare finance leaders from across the Western region for a week of education, innovation, and industry-wide collaboration.

As sponsors, we’re excited to support an event that drives meaningful conversation around the future of healthcare finance. If you’ll be attending, we’d love to connect with you throughout the week — stop by, say hello, or reach out to coordinate a time to meet during the conference.

Learn more & register:

http://bit.ly/48Qp1q3 All articles are written by the SAC Litigation team. The SAC Litigation team includes attorneys, nurses and physicians with extensive experience in all areas of law related to healthcare matters. Additionally, SAC partners hold legal advisory positions with healthcare organizations and sit on the boards of numerous healthcare-related organizations, and monitor all outgoing SAC client marketing materials and related content.

DISCLAIMER: This newsletter is for general educational and informational purposes only. You should not act upon this information without seeking your own independent professional advice.

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