BAMC patients still having checks garnished to pay bills despite new protections

If you're injured in an emergency, there's a good chance you'll be rushed to Brooke Army Medical Center. The military hospital is one of two Level One trauma centers in San Antonio and specializes in burn treatment.

For five years now, the News 4 I-Team has been reporting on civilian patients struggling with crushing medical debt from BAMC.

The military has been slow to implement payment options passed by congress. Many former BAMC patients are still having their paychecks garnished and tax refunds withheld, despite protections that were supposed to reduce the burden on families experiencing hardship.

Ty Ybarra was still in high school when, just a few days after his eighteenth birthday, he was badly burned in a fireworks accident and taken to BAMC.

"You can probably still see the scarring right here, it's a little lighter on the texture, and right here, and on my face," Ybarra said while pointing to where he suffered third-degree burns.

Ty's parents were divorced, did not have insurance, and could not pay the $20 thousand medical bill.

Five years later, when Ty was on his own, living in a trailer and working his first real job, the U.S. Treasury Department sent him the bill. With interest and penalties it had swelled to more than $36 thousand.

Ty says he went to speak to the billing department.

"To see if I could cancel it and get it resolved then and there. I never heard anything else from the federal government about it until I saw my paycheck getting garnished," Ybarra said.

Over the years we've heard similar stories from people all over South Texas, both insured and uninsured.

A huge bill they thought had been resolved arriving out of the blue, followed by 15 percent of their paychecks or social security checks being garnished along with their tax refunds.

"Somebody's unconscious, they really don't have a choice what hospital they're going to, they end up at BAMC, and BAMC is out of network with all the insurance companies, doesn't really work with insurance companies much, so people would get stuck with these huge bills," said Congressman Joaquin Castro.

We contacted the Treasury Department which responded: "Treasury is statutorily mandated to collect on debts certified by other agencies, like BAMC. We are committed to ensuring the process is fair with opportunities to contest the debt, and request payment arrangements for relief if they are facing financial hardship."

Castro has passed amendments to military spending bills the last few years which allow BAMC to waive certain bills or charge people on a sliding scale according to their income. But they only included patients treated after June of 2023.

Now Castro has authored a new amendment to the 2025 defense spending bill that would pause collections for all civilian patients until they receive payment plans that provide financial relief.

Even if they were treated years ago, like Ty Ybarra.

"It's pretty difficult to get by," Ybarra said.

The amendment is still moving through congress and we'll let you know if it passes closer to the end of the year.

The following is a statement sent to News 4 from BAMC late Thursday afternoon:

"BAMC is honored and privileged to provide Level I trauma care to our community, and we work closely with our civilian emergency patients to help ensure a smooth billing process. We have reached out to Mr. Ybarra to offer our support and to answer any questions regarding the process.

As a federal entity, all military medical treatment facilities, to include BAMC, are required to follow existing regulations and policies for collections of federal debt; they do not have the authority to write off or waive a valid debt under federal law.

To help alleviate billing concerns, the Defense Health Agency, with BAMC's input, is developing a graduated pay scale recommendation for civilian patient bills based on ability to pay, which will require congressional approval for implementation. Until the guidance is finalized, DHA has directed (and BAMC has implemented) a hold on bills to non-beneficiaries who received care on or after June 21, 2023. This applies to the portion of the bill after Other Health Insurance (OHI) pays or the self-pay portion for uninsured.

Prior to June 2023, if civilian patients were unable to pay, their accounts would have been transferred according to existing statutes to the Debt Adjudication Management Program, which is managed by the U.S. Department of Treasury Centralized Receivables Service Program.

Whether an older or more current bill, we encourage our patients to contact the BAMC Uniform Business Office if they have any questions and, if applicable, to reach out to their insurance carrier to clarify their policy and coverage. To contact UBO, email or call (210) 916-8563/5772. UBO can help validate bills and assist with insurance claims and payment plans. To learn more about the billing process, please visit: UBO-billing-brochure.pdf (tricare.mil)

As one of two Level I Trauma Centers alongside University Health, BAMC provides lifesaving care to more than 4,000 trauma patients annually (to include 750 patients treated in the U.S. Army Institute of Surgical Research Burn Center) from across 22 counties in Southwest Texas. BAMC's enduring trauma mission ensures military physicians, nurses and allied health professionals are always ready to deploy anywhere in the world to care for service members.

As always, BAMC is proud to provide world-class healthcare to our community and our Nation."