- Abdul El-Sayed, a former public health official, has highlighted his work in Detroit and Wayne County prominently in US Senate bid
- His efforts to erase $700 million in Wayne County medical debt have made progress, but the program has only settled $57.38 million so far
- As a public health director, El-Sayed also prioritized free glasses for students, access to Narcan, air quality and lead removal in schools
In stump speeches, debates and statewide ads, Michigan Democratic US Senate candidate Abdul El-Sayed frequently touts his experience as a Wayne County health director, where he worked to ease the burden of medical debt on residents who couldn’t afford to pay.
“$700 million medical debt erased,” his campaign’s first major TV ad proclaims. In a June forum, he called the county’s work on medical debt relief “the biggest medical debt erasure in Michigan state history.”
While the program, launched under El-Sayed in 2024, does seek to erase up to $700 million in medical debt for 300,000 residents by buying it from providers at a bulk discount, that hasn’t happened yet.
More than two years in, Wayne County says it has so far paid off the equivalent of $57.4 million in medical debt for 83,291 residents, far less than the ambitious goal El-Sayed promotes on the campaign trail.
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The county partnered with national nonprofit Undue Medical Debt on the project, signing a two-year, $5 million contract, with an option to add another $2 million if local officials approve. Records show just under $400,000 from the county has been used so far in debt settlement deals.
El-Sayed campaign spokesperson Roxie Richner characterized the program as “active and in progress,” noting the county approved the needed funds to settle $700 million while he headed the department.
More Wayne County debt purchases are currently in the works, Courtney Werpy Story, Undue Medical Debt’s vice president of government initiatives, told Bridge Michigan. She expected it would take more time and negotiations with medical providers to get the full amount settled.
“Typically for us, it takes about a year to two years to really get going with a program, to build those relationships with hospitals and providers,” she said, noting that for most hospitals, selling off debt is a “new process.”
Medical debt relief is one of many initiatives El-Sayed led in prior public health leadership roles that have faced increased scrutiny as he seeks the Democratic nomination for Michigan’s open US Senate seat.
His three-way primary battle with US Rep. Haley Stevens and state Sen. Mallory McMorrow, along with the winner’s eventual general election matchup against Republican Mike Rogers, make Michigan’s Senate race one of the most closely-watched in the country.
Beyond medical debt relief, El-Sayed has worked to remind voters of his work to offer free glasses for children in Detroit and Wayne County, increase public access to Narcan, address lead issues in schools and improve available air quality data.
Critics have raised concerns about some aspects of his work, however, arguing his 2023 public health emergency order to address safety concerns at the Wayne County Juvenile Detention Facility didn’t resolve poor conditions at the facility.
Ahead of the Aug. 4 primary election, Bridge analyzed key aspects of El-Sayed’s public health background that he has touted on the campaign trail, and will similarly review the past work of other US Senate candidates.
Medical debt relief
In a May rally with US Sen. Bernie Sanders, El-Sayed claimed Wayne County “erased $700 million of medical debt” but later more accurately acknowledged that the figure remains an aspirational goal.
“When we found out that … we could eliminate it for pennies on the dollar, guess what we did? We set aside $7 million to erase up to $700 million of medical debt,” he said.
Speaking to a US Senate committee in July 2024 as county health director, El-Sayed shared a personal reason why easing the burden of medical debt was a priority to him: A year prior, he’d developed an inguinal hernia that required preventive surgery. Insurance didn’t cover all of it, meaning he had to cover nearly $5,000 in out-of-pocket costs.
“Had I not been insured, had I not had the means to pay my out-of-pocket costs…I might have wound up being one of the millions of people in this country with medical debt,” he said. “These impossible choices too many Americans are forced into are why we hold so much debt in this country.”
El-Sayed contends the best long-term solution to health care affordability is a national single-payer “Medicare for All” system, a path he and other progressives argue would prevent people from accruing steep medical debts in the first place.
As a public health official, he pitched erasing medical debt as the next best thing for residents who couldn’t pay bills or experienced an unexpected health emergency, saying the government — in partnership with Undue Medical Debt — had leveraging power to negotiate down debts.
The program, approved by Wayne County commissioners in 2024, benefits residents who earn less than 400% of the federal poverty level or whose medical debt exceeds 5% of their overall income. Qualifying residents don’t apply, but are notified via letter if their debt is purchased and erased.
Undue Medical Debt works to buy medical debt in bulk below face value from hospitals, other providers and medical debt collectors. Oakland and Kalamazoo counties funded similar local programs using federal funds that are active through the end of the year. The state of Michigan also works with the group, announcing this week that $200 million in statewide medical debt has been wiped clean since that partnership began.
Werpy Story of Undue Medical Debt said the nonprofit is currently in talks with Wayne County officials on the possibility of extending the contract. The group views Michigan’s combined local and state efforts to alleviate medical debt as “one of the national models for government-led relief,” she said.
“We’re going to continue to chip away at it, and this is very normal for our work,” she said, later adding: “Hospitals have so many competing priorities right now, especially as the federal landscape continues to change, so it unfortunately just takes time.”
But the county’s program has run into roadblocks. In May, freelance journalist Kayleigh Lickliter reported two of Detroit’s three major hospital systems, DMC and Corewell Health, aren’t yet participating.
Because there’s no way to publicly track whose debts are being erased, some county commissioners have questioned the program’s transparency.
During a Feb. 10 discussion on the issue, Commissioner Monique Baker McCormick said she “just would like to have some accountability” as she hadn’t heard from anyone who had personally benefited from the program.
Fellow Commissioner Allen Wilson agreed, suggesting debt relief efforts were “cloaked in secrecy.”
“It’s very challenging to me when individuals in my community or my district say to me, ‘Hey, is there such thing as a medical debt relief? I read about it somewhere, but I don’t know anybody who received it,’” he said.
Glasses guarantee
In his capacity as health director in both Detroit and Wayne County, El-Sayed prioritized free access to glasses for kids through a mobile eye care clinic, partnering with the national nonprofit Vision to Learn to do so.
He has frequently referred back to the initiative as a success story: A 2025 campaign video features El-Sayed sporting large circular frames and calling the initiative “one of the most important programs we built,” and claiming the program delivered “tens of thousands of pairs of glasses.”
His more recent statewide ad claims the program has delivered 16,000 glasses to local kids.
The latter claim appears to be more accurate. The nonprofit has provided “tens of thousands” of glasses statewide, but not just in Detroit or Wayne County, where El-Sayed worked.
The original partnership began in October 2016 while El-Sayed served as Detroit health director. By the time he resigned to run for governor in February 2017, the city had provided nearly 1,000 pairs of glasses to city students.
When he returned to public health as Wayne County’s director, he expanded the Vision to Learn partnership countywide with the help of a $1.1 million federal grant backed by then-US Sen. Debbie Stabenow.
The California-based Vision to Learn also expanded to other Michigan communities, reporting in its 2024-25 annual report that 41,860 pairs of glasses had been delivered statewide.
El-Sayed’s campaign told Bridge the 16,000 figure he touts in his ad encompasses his work in both roles: 6,000 glasses for Detroit residents and 10,000 for Wayne County residents. Vision to Learn’s website currently states more than 5,000 glasses have been distributed to Detroit students, the city’s original goal, and county officials in February reported 10,000 glasses had been distributed so far.
Sean Washington, a 21-year-old Detroit resident, benefited from the Vision to Learn program in 2016 as a young student when his mother heard about the program and decided to participate.
“I wasn’t really sure where the glasses were coming from. All I knew was, I needed some glasses,” he said. “It really did help me with my academic attainment, knowing that I can see.”
Years later, Washington made the connection to his own experience when he began researching El-Sayed’s background in the US Senate race. He eventually had the chance to meet him and thank him for supporting the program.
“It does give you a sigh of relief, knowing that there are people that are willing to be there for you, even when you don’t know who they are, what their name is at the time,” he said. “I think that’s a blessing.”
Water and air quality
After the Flint water crisis rocked the state and some Detroit schools reported having higher-than-normal lead levels, El-Sayed, then Detroit’s health director, pushed to have all schools and early childhood centers in the city tested for lead in the water.
He also increased lead testing among Detroit children and created the city’s Lead Safe Coalition to coordinate childhood lead prevention and lead abatement efforts. In 2016, his department reported a decrease in elevated lead levels among children under 6.
“The goal is two things: to make sure we are aware of every child that’s lead exposed in Detroit and then get every child that has been exposed access to every possible service we can provide,” he told The Detroit News in August 2016.
As a US Senate candidate, El-Sayed has frequently referenced these efforts, noting on his website that he “removed lead from Detroit’s elementary schools.” During an April 7 rally at Michigan State University, he said the effort “got all the schools on a pathway to be lead-free, and helped to rewrite the state’s lead policy.”
Detroiters continue to grapple with lead exposure — the city estimates at least 80,000 residential lead service lines are still in use, and in 2018, Detroit public schools temporarily shut off drinking water as a precautionary measure after tests showed elevated lead and copper levels.
But El-Sayed’s early advocacy appears to have made a lasting impact in the city, where the health department has maintained its list of lead test results in school buildings, a childhood lead prevention program and other abatement efforts.
The Detroit programming predated statewide lead safety requirements like the 2023 Clean Drinking Water Access Act, which required schools to install water filters and create a drinking water management plan, and universal blood lead testing for all Michigan children at 12 and 24 months.
It’s unclear whether El-Sayed played any specific role in advising state policymakers who drafted those legislative and administrative changes.
El-Sayed’s campaign has also frequently referenced his work to improve air quality, including his fight against Marathon Petroleum’s request to increase emissions in 2016 that resulted in the company retooling its plans and the deployment of air quality monitors across Wayne County.
Narcan access
While El-Sayed led the Wayne County health department, the county entered a partnership with the Center for Behavioral Health and Justice at Wayne State’s School of Social Work to expand public access to free naloxone, commonly known as Narcan, and testing kits for fentanyl and xylazine.
To do so, the department set out to place 100 vending machines around the county containing a free supply of Narcan with the goal of helping combat an increase in overdose deaths. At the time, the program was billed by advocates as the largest investment in naloxone access in US history.
“Naloxone is a life-saving medication, one that should be available everywhere if we’re serious about fighting this crisis,” El-Sayed said as the county launched the program in 2024.
The Well Wayne Stations initiative, launched in 2024 under El-Sayed, remains active, with the county dashboard showing 96 total stations in 92 locations up and running. More than 36,000 Narcan kits have been distributed.
Though Wayne County has experienced a significant decline in overdose deaths, it continues to experience the highest number of overdose deaths in Michigan, the Center for Behavioral Health and Justice reported this month.
This year, during an April rally at Michigan State University, El-Sayed laid some of the blame at the feet of GOP US Senate candidate Mike Rogers, who advocated for expanded opioid access for pain relief when he served in Congress, beginning in the early 2000s.
The Wayne County anti-overdose effort was a way “to try and do our part to save people’s lives from the opioid epidemic that he and his corporate overlords told us was in our best interest,” El-Sayed said.
Rogers recently hit back at El-Sayed’s attacks, sending his campaign a cease-and-desist letter for alleging that he was a lobbyist who took money from special interests.
In a video posted to social media, Rogers accused El-Sayed of misleading the public: “The truth is, Abdul El-Sayed would much rather lie to Michigan voters about who I am than be honest to you about who he is.”
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