Nearly 45,000 Cook County residents have received letters in the mail, telling them that — without even asking for it — their medical debt has been erased.

Another batch of letters will be going out soon, with more good news.

In total, this represents nearly 73,000 people who are having their medical debt abolished.

“This is just the beginning,” Cook County Board President Toni Preckwinkle said during a news conference on Wednesday.

A recent report detailed the devastation medical debt causes Illinois families — particularly in immigrant and Black communities — causing stress that impacted their health and depleted their savings.

Preckwinkle announced that so far the county in partnership with national nonprofit RIP Medical Debt has acquired nearly $80 million in debt. Of that, around $25 million of the debt was sold and erased in February. Another $54 million in debt is set to be abolished imminently.

“I have to say Cook County is a trendsetter,” said Allison Sesso, president and CEO of RIP Medical Debt. “There’s been many other cities, states and counties that have knocked on our door with this innovative approach.”

Through this new initiative, the county and RIP are using $12 million in federal pandemic relief dollars to erase up to $1 billion in debt. So far the county has spent around $800,000 on the effort. RIP Medical Debt is able to negotiate down the cost of the debt when selling it to buyers on the for-profit market. With $1, RIP has relieved as much as $100 of medical debt or more at a time, Sesso said.

“The people that received letters … often are in disbelief that this is a real thing,” Sesso said. “I want to assure people that this is real.”

RIP buys the debt from hospitals and other health care providers. That means patients can only get their debt erased if the facilities that treated them sell it — people can’t apply for their debt to be wiped out.

The debt erased in Cook County comes from Sinai Chicago, a health system that largely treats low-income patients of color on the West and Southwest Sides, and Vituity, a physician-owned organization that provides contracted doctors and physician assistants at hospitals across the U.S.

Sesso said it could take a few years to erase up to $1 billion in medical debt in Cook County. It depends how many hospitals and other health care providers sign on to sell their debt.

“Nobody’s heard of this before,” Sesso said. “Frankly hospitals are bureaucracies and you have to sort of weed your way through them.”

During the news conference, Thor Thordarson, president and CEO of AdventHealth in the Great Lakes Region, announced that his hospital system would sell medical debt to RIP. He said too many patients fall through cracks, even if they have good insurance.

And he shared a personal story, about having “very premature twins” 34 years ago.

“The number of bills that come home along with the kids, and the size, was astronomical,” Thordarson said. “It’s eye-watering. There’s no way we could have paid for this.”

He said even though he and his wife made good salaries and had good insurance — he was a nurse and his wife a teacher — they struggled, and likely would still be paying off the bills today if it wasn’t for a group of physicians who waived the major portion of their fees.

“I can only imagine folks on the margin who are struggling,” Thordarson said. “We don’t want them to have to choose between good health and financial devastation.”

So far, of the data available about people whose debt has been acquired in Cook County, nearly 60% earn up to $25,000 a year. Almost 50 percent are 45 years old or younger. In data around race, around 48% of people are Black and 48% identified as white. Separately in ethnicity data, about 57% identified as Hispanic or Latino.

The top 10 ZIP codes where people whose debt is being abolished live are concentrated on the South and West Sides, and in suburbs just west of the city, including Cicero and Berwyn.

The ZIP code where the most debt was acquired — nearly $15 million from around 5,600 people — is just west of Englewood on the city’s South Side.

Kristen Schorsch covers public health and Cook County government for WBEZ.