BREANNE ARMBRUST: This is our large meeting room.

BILLY SHIELDS: Breanne Armbrust is the executive director of the Neighborhood Resource Center inside this small storefront in the Fulton area of Richmond.

Its members often come to the organization in dire need.

BREANNE ARMBRUST: We have a computer lab that we use for individuals to apply for positions and...

Many of our members end up going to the emergency room for their typical care because they may not have a primary care provider.

Most of our members come to us uninsured.

BILLY SHIELDS: She remembers one member who had mounting medical debt which may have contributed to even more health issues.

BREANNE ARMBRUST: They had already been approved for the bankruptcy, and were in the bankruptcy process of paying down, you know, their debt with an agreement.

That individual over the course of the first few months that I was working with them, experienced a heart attack.

BILLY SHIELDS: It's something that creates an all-too-familiar problem, the problem of medical debt.

BREANNE ARMBRUST: Thinking ahead to think that in some point in the future I may have a medical catastrophe is, you know, something that I do think our members do, but it's a choice between paying for health insurance for something that might happen or paying for your rent or buying food.

LAURA ALRIDGE: I would say the majority of our clients do have medical debt.

It's something that we see frequently, and it is one of the leading causes, if not the most leading cause, of people filing for bankruptcy.

BILLY SHIELDS: Laura Alridge is a bankruptcy lawyer at the Boleman Firm in Richmond.

She says many different life events can precipitate a health emergency that takes someone over the edge.

LAURA ALRIDGE: It can also be the loss of employment or the breakup of a family unit, but certainly medical debt plays a very, very large role, and sometimes what people do is they start paying the medical debt with their credit cards.

BILLY SHIELDS: Bankruptcy is the most common legal remedy.

Alridge volunteers her time providing pro bono legal assistance for CancerLINC, a Richmond nonprofit that helps people with the financial repercussions of a cancer diagnosis.

CHRIS WILLIAMS: One example may be someone who's working an hourly labor job who tells their employer that they need to take time off for treatments, and after they do that for a certain amount of time, many times we'll have an employer who then tells that employee, "Well, you need to resign because we can no longer allow you to take time off," and generally, of course, those folks, when they're not on the job, they're not being paid, so debt happens there and then they lose their job, so they have no income.

BILLY SHIELDS: Chris Williams remembers having a migrant man approach him for help.

CHRIS WILLIAMS: And went to the hospital and was diagnosed with malignant cancer, brain cancer, and his decision immediately was to not be treated for that cancer because he knew the financial effects that he would leave for his wife and child, and that just, it tore me up.

BILLY SHIELDS: Armbrust was part of an innovative solution to medical debt.

BREANNE ARMBRUST: Last year, we participated in an effort with an organization called RIP Medical Debt, and they purchased, they're a nonprofit that purchases debt portfolios of medical debt, and then they abolish it.

BILLY SHIELDS: She knows this situation all too well.

She says she was lucky to have insurance that spared her from taking on medical debt.

BREANNE ARMBRUST: I've experienced that.

I was privileged when I was younger to work in environments where I had very, very good healthcare, and so when I experienced a brain tumor that I had to have surgery for, I had to have two brain surgeries over the course of five years, and the last one resulted in a stroke.

When I added up all of those medical bills, it would've been over $2 million for me out of pocket if I didn't have the health insurance that I had.

Even for people that have private health insurance, we have a system that is damaged.

BILLY SHIELDS: So, what can be done to address this?

LAURA ALRIDGE: Obviously, the system is broken.

BILLY SHIELDS: Alridge and Armbrust both use different means to help people facing medical debt.

Whether out of a Northside law firm or in Fulton Bottom, both women say suffering from chronic debt should not be an affliction of its own.

For VPM News, I'm Billy Shields.