Roger Marshall Bets His Kansas Closing Argument on Defending Patient Lawsuits

Roger Marshall Bets His Kansas Closing Argument on Defending Patient Lawsuits

A 60-second video becomes the closing message

With Election Day hours away, Senator Roger Marshall, Republican of Kansas, made his treatment of patients the centerpiece of his closing pitch. According to the Washington Post, Marshall recorded a roughly 60-second video asking Kansas voters to "know the truth" about his years as the only obstetrician serving a largely rural part of central Kansas. The video did not run on television or as paid digital advertising, according to the ad-tracking firm AdImpact; it circulated online after a Kansas City talk radio host posted it on a Saturday evening, with county Republican accounts sharing it further.

Keeping the lights on for 40,000 patients

Marshall's official line is financial survival in the name of access. "To ensure that 40,000 Kansans still had access to care, we did have to keep the lights on," he says in the video. "So we occasionally handed accounts over to collection agencies, just like nearly every private medical practice does." He adds that the practice wrote off hundreds of bills every month and gave free care to one in five patients. He previously told CNN that his hospital gave away millions of dollars in charity care each year.

More than 700 suits, 81 arrests, 13 warrant requests

The controversy traces to a September New York Times investigation, which found that Marshall and his practice sued more than 700 patients over unpaid bills during about 25 years as an obstetrician-gynecologist, with balances ranging from several thousand dollars down to $101. Eighty-one former patients were arrested after failing to appear in court, and The Hill reports that attorneys for Marshall requested arrest warrants in 13 cases. A Kansas City Star analysis of roughly 150 Kansas medical practices found Marshall's 18 percent annual rate was the highest in the state, with no other provider specifying a rate above 12 percent.

A former patient sues back over the 18 percent rate

On October 29, Meischa Zimmerman, a former patient featured in the Times report and later in Hamilton attack ads, filed a class-action lawsuit in Barton County District Court against Marshall and his former Great Bend practice, Heartland Regional OBGYN. According to the Kansas Reflector, the suit calls the billing a "callous and predatory" scheme that routinely charged 18 percent annual interest, above Kansas's 15 percent statutory cap, and seeks restitution and damages. The complaint says Zimmerman owed $3,596 from a 2009 cesarean delivery and was arrested three times over missed court dates, once while eight months pregnant and home with her 2-year-old daughter. KWCH reports she puts the disputed bill at about $3,000.

Drawing a line at the collection agency's door

Marshall's defense rests on separation: once an account left his office, it was no longer his decision. "My involvement in any patient's account ended the minute it was turned over to an outside agency," he says in the video. "I never had anyone arrested, not once, and Adam Hamilton knows it." He has repeatedly said he never set the interest rate himself. President Donald Trump defended him on October 13, claiming Marshall was legally required to pursue the debts, but a CNN fact check found no such requirement: state and federal law leave doctors wide latitude to forgive debts or use gentler collection methods.

What comes next: ballots on November 3, then the courtroom

Marshall, born in El Dorado, earned his medical degree from the University of Kansas School of Medicine in 1987, served seven years as a captain in the U.S. Army Reserves, and practiced obstetrics and gynecology in Great Bend for more than 25 years before entering the U.S. House in 2017. He now faces Democrat Adam Hamilton, a pastor, in a November 3 election that polls suggest is unexpectedly competitive. The class action in Barton County will outlast the campaign, and a court will decide whether the 18 percent rate violated Kansas law and who bears responsibility for the arrests.