As a longtime doctor in rural Kansas, Roger Marshall often mentions that he delivered more than 5,000 babies over his career before getting into politics.

Marshall, now Kansas’ junior Republican U.S. senator, spent more than 25 years as an OBGYN, sharing in families’ happiest and most challenging moments.

He also aggressively pursued hundreds of former patients over unpaid medical bills, according to a new bombshell report published by The New York Times.

The investigation found that Marshall sued more than 700 patients, leading to at least 81 arrests when patients missed court dates. Marshall charged an 18% annual interest rate on unpaid bills and in some cases garnished patients’ wages and bank accounts, The Times reported.

Marshall’s campaign pushed back at the Times’ reporting, describing his approach to collecting on debts as “a rural doctor keeping the hospital’s lights.”

But the Republican senator’s critics seized on the revelations about Marshall’s extensive litigation against patients.

Former Kansas Gov. Kathleen Sebelius, a Democrat who went on to serve as secretary of Health and Human Services in the Obama administration, said she was “shocked and disappointed” to learn about Marshall’s “unbelievably aggressive practice of going after people who just had a baby or fell on hard times.”

“While I fully understand that providers need to be paid — they are not delivering free services — a lot of providers that I know turn around and then are on the front lines of fighting for expanded health insurance, fighting for people to have more affordable options to pay,” said Sebelius, who served two terms as Kansas insurance commissioner before she was elected governor.

In Washington, Marshall has repeatedly voted to repeal or scale back the Affordable Care Act. The ACA, also commonly known as “Obamacare,” has expanded health insurance coverage for Americans in the 16 years since it became federal law.

Payton Fuller, a spokesperson for Marshall’s campaign, said in a statement to The Star that for decades, Marshall “treated every single patient who came through the doors regardless of their ability to pay.” She added that his Great Bend practice “welcomed Medicaid patients while other providers turned them away.”

Unpaid medical bills

The Times interviewed eight people Marshall sued between 2003 and 2015 over unpaid bills. The news story says most interviewees described themselves as living from paycheck to paycheck and said they often had to choose between paying medical bills or buying groceries.

Two such patients said the bills Marshall pursued in court stemmed from late miscarriages that required surgery.

“Roger Marshall must explain to Kansans why he had patients arrested and jailed over tiny debts before going to Congress to vote to take away Kansans’ health coverage,” said Tyson Brody, a spokesperson for the Rev. Adam Hamilton, the Democratic nominee challenging Marshall for his seat in November.

In response to a request for comment, Marshall’s campaign provided the same statements that were quoted in the Times story.

“Judges issue warrants when people repeatedly miss court dates, not doctors,” said Fuller, Marshall’s spokesperson. “Any other suggestion is a gross mischaracterization, and the New York Times knows that.”

Barak Richman, the co-director of the health law program at George Washington University, told The Times that there is “a lot of variation” in how doctors across the country handle unpaid bills — from filing lawsuits to hiring debt collectors or forgiving debts for patients who can’t afford to pay.

As insurance deductibles have risen in recent years, more hospitals and doctors have turned to litigation. But Richman, who has studied medical debt litigation in three states, said that wage garnishments and arrests of patients are “definitely on the extreme side.”

‘Do no harm’

Healthcare expenses remain the number one cause of bankruptcies in the U.S.

Sebelius, who led the federal agency responsible for the nation’s public health and social services during the rollout of the ACA, said Marshall’s litigation tactics against hundreds of patients represents “a great aberration of ‘do no harm,’ which is the basic Hippocratic Oath that doctors take.”

“This is a guy who then gets elected to Congress coming out of this very personal situation of seeing how many people are struggling to pay their medical bills and votes over and over and over again to take away health insurance from his constituents,” Sebelius said.

Families can’t predict when a medical emergency will occur or what complications a pregnancy might entail, Sebelius said.

“The worst of all words is to have a tragedy followed then by somebody pursuing you — up to and including putting you in jail,” she said.

Marshall’s campaign defended the tactics attorneys representing Marshall and his practice used to collect on outstanding medical bills as the same as “every other business or hospital in Kansas.”

The Sunflower State is one of 10 in the U.S. that has not opted to expand Medicaid under the ACA. According to a recent analysis by the nonpartisan Centers for Healthcare Quality and Payment Reform, Kansas has 28 rural hospitals at immediate risk of closure — more than in any other U.S. state.

_____

©2026 The Kansas City Star. Visit kansascity.com. Distributed by Tribune Content Agency, LLC.