MacKenzie Scott's Three Gifts Totaling About $130 Million Helped Undue Medical Debt Cancel Over $40 Billion in Bills

MacKenzie Scott has given Undue Medical Debt, formerly RIP Medical Debt, about $130 million in three gifts since 2020. The charity says it has abolished more than $40 billion in medical debt across all 50 states.

The gifts came in 2020 ($50 million), 2022 ($30 million) and 2024 ($50 million). The Times of India, citing Fortune, called the third donation, made in December 2024, a rare one.

How the model works

Hospitals and doctors routinely sell unpaid patient bills in bulk at steep discounts. Undue Medical Debt buys those bills at similar discounts, then cancels them instead of chasing patients for payment.

The charity says every $1 donated erases about $100 in debt. That is the same math as $10 retiring roughly $1,000.

What the $40 billion figure is

The $40 billion is the charity's own cumulative total of debt abolished. It is a figure the charity reports itself. The sources do not break that total down by donor, so they do not show how much of it traces to Scott's three gifts. Reports describe her gifts as having helped the charity erase tens of billions of dollars in medical debt, which is different from saying her money alone erased $40 billion.

Where the money comes from

Scott received a 4% Amazon stake in her 2019 divorce from Jeff Bezos. Forbes reports she has since sold more than 75% of those shares. Forbes also estimates she has given $26.4 billion to more than 2,500 charities in under seven years.

Those are Forbes estimates, not figures from Scott.

The criticism

Scott's approach differs from most billionaire philanthropy. Her grants come with no strings attached, no spending deadlines and minimal reporting requirements.

That structure has drawn criticism. Elon Musk has publicly criticized her philanthropy. More recently, Musk responded "Sadly yes" to a post claiming that Scott was "spending it making the world a worse place." In 2024, he shared a post that appeared to reference her without naming her, then later deleted it.

With minimal reporting requirements, outsiders have to rely on the charities' own numbers. In the medical-debt case, that means the charity's own tally.

The model also has a basic limit. Each cancellation clears debt that already exists. The charity's approach is to buy and cancel old bills, not to change how hospitals bill patients.

From a taxpayer's standpoint, there is one point in the plan's favor. This is private money, voluntarily given, with no government appropriation involved. Nobody was handed the bill.

Scott's wider giving

Scott recently passed $1 billion in donations to historically Black colleges and universities, a separate milestone. Last month, her $42 million donation to Elizabeth City State University in North Carolina took her HBCU total well past that mark. In November 2025 she gave Howard University $80 million.

What is still open

The sources do not say how much of the $40 billion her three gifts account for. Only Undue Medical Debt can answer that, by publishing its funding sources against what it has canceled.