St. Paul, Minnesota, has initiated a significant medical debt forgiveness program, erasing $40 million in debt for 32,000 residents without requiring applications. This effort, led by Mayor Melvin Carter, utilizes $1.1 million in federal COVID relief funds and partners with the nonprofit Undue Medical Debt to negotiate and purchase debt at reduced rates before forgiving it. The program targets residents earning up to 400% of the federal poverty level or whose medical debt exceeds 5% of their annual income, as part of a broader plan to forgive $110 million in total medical debt. The initiative is expected to improve credit scores and healthcare access, especially benefiting communities of color. It also aligns with state legislation like the Minnesota Debt Forgiveness Act, which prevents denial of necessary care due to unpaid debts.