Business

Health care providers and debt collectors are biting from people’s paychecks to cover old medical bills

Published

4 months ago

September 29, 2025

Stacey Knoll thought the court summons she received was a scam. She didn’t remember getting any medical bills from Montrose Regional Health, a nonprofit hospital, after a 2020 emergency room visit.

So she was shocked when, three years after the trip to the hospital, her employer received court orders requiring it to start funneling a chunk of her paychecks to a debt collector for an unpaid $881 medical bill — which had grown to $1,155.26 from interest and court fees.

The timing was terrible. After leaving a bad marriage and staying in a shelter, she had just gotten full custody of her three children, steady housing in Montrose, Colorado, and a job at a gas station.

“And that’s when I got that garnishment from the court,” she said. “It was really scary. I’d never been on my own or raised kids on my own.”

KFF Health News reviewed 1,200 Colorado cases in which judges, over a two-year period from Feb. 1, 2022, through Feb. 1, 2024, gave permission to garnish wages over unpaid bills. At least 30% of the cases stemmed from medical care — even when patients’ bills should have been covered by Medicaid, the public insurance program for those with low incomes or disabilities. That 30% is likely an underestimate since medical debt is often hidden behind other types of debt, such as from credit cards or payday loans. But even that minimum would translate to roughly 14,000 cases a year in Colorado in which courts approved taking people’s wages because of unpaid medical bills.

Among the other findings:

Patients were pursued for medical bills ranging from under $30 to over $30,000, with most of the bills amounting to less than $2,400. As the cases rolled through the legal system, accumulating interest and court fees, the amount that patients owed often grew by 25%. In one case, it snowballed by more than 400%.
Cases trailed people for up to 14 years after they received medical care, with debt collectors reviving their cases even as they moved from job to job.
Medical providers of all stripes are behind these bills — big health care chains, small rural hospitals, physician groups, public ambulance services, and more. In several cases, hospitals won permission to take the pay of their own employees who had unpaid bills from treatment at the facilities.

Colorado has company. It is one of 45 states that allow wage garnishment for unpaid medical bills. Only Delaware, New York, North Carolina, Pennsylvania, and Texas have banned wage garnishment for medical debt.

As KFF Health News has reported, medical debt is devastating for millions of people across the country. And now the problem is likely to grow more pressing nationwide. Millions of Americans are expected to lose health insurance in the coming years due to Medicaid changes in President Donald Trump’s tax and spending law and if Congress allows some Affordable Care Act subsidies to expire. That means health crises for the newly uninsured could lead them, too, into a spiral of medical debt.

And the hurt will linger: Large unpaid medical bills are staying on credit reports in most states after a July decision from a federal judge reversed a new rule aimed at protecting consumers.

“If you can’t maintain your health, how are you going to work to pay back a debt?” said Adam Fox, deputy director of the Colorado Consumer Health Initiative, a nonprofit aimed at lowering health costs. “And if you fundamentally can’t pay the bill, wage garnishment isn’t going to help you do that. It’s going to put you in more financial distress.”

Flying blind on medical debt

When someone fails to pay a bill, the creditor that provided the service — whether for a garage door repair, a car loan, or medical care — can take the debtor to court. Creditors can also pass the debt to a debt collector or debt buyer, who can do the same.

“At any given point, about 1% of working adults are being garnished for some reason,” said Anthony DeFusco, an economist at the University of Wisconsin-Madison, who studied paycheck data from ADP, a payroll processor that distributes paychecks to about a fifth of private sector U.S. workers. “That’s a big chunk of the population.”

But specific research into the practice of garnishing wages over medical debt is scant. Studies in North Carolina, Virginia, and New York have found that nonprofit hospitals commonly garnish wages from indebted patients, with some studies finding those patients tend to work in low-wage occupations.

Marty Makary, who led research on medical debt wage garnishment in Virginia at Johns Hopkins University before joining Trump’s cabinet as Food and Drug Administration commissioner, has called the practice “aggressive.” He co-authored a study that found 36% of Virginia hospitals, mostly nonprofit and mostly in urban areas, were using garnishment to collect unpaid debts in 2017, affecting thousands of patients.

The Colorado findings from KFF Health News show that hospitals are far from the only medical providers going after patients’ paychecks, though.

Researchers and advocates say that, in addition to a dearth of court case data, another phenomenon tends to obscure how often this happens. “People find debt shameful,” said Lester Bird, a senior manager at the Pew Charitable Trusts who specializes in courts. “A lot of this exists in the shadows.”

Without data on how often this tactic is employed, lawmakers are flying blind — even as a 2024 Associated Press-NORC poll showed about 4 in 5 U.S. adults believe it’s important for the federal government to provide medical debt relief.

‘Blood from a turnip’

Colorado was among the first of 15 states to scratch medical debt from credit reports. Debt buyers in the state aren’t allowed to foreclose on a patient’s home. If qualified patients opt to pay in monthly installments, those payments shouldn’t exceed 6% of their household income — and the remaining debt gets wiped after about three years of paying.

But if they don’t agree to a payment plan, Coloradans can have up to 20% of their disposable earnings garnished. The National Consumer Law Center gave the state a “D” grade for state protections of family finances.

Consumer advocates said they aren’t sure how well even those Colorado requirements are being followed. And people wrote letters to the courts saying wage garnishment would exacerbate their already dire financial situations.

“I have begun to fall behind on my electricity, my gas, my water my credit cards,” wrote a man in western Colorado in a letter to a judge that KFF Health News obtained in the court filings. Court records show he was working in construction and at a rent-to-own store, with about $8,000 in medical debt. He wrote to the judge that he was paying close to $1,000 a month. “The way things are going now I will lose everything.”

The people being sued in KFF Health News’ Colorado review worked in a wide array of jobs. They worked in school districts, ranching, mining, construction, local government, even health care. Several worked at stores such as Walmart and Family Dollar, or at gas stations, restaurants, or grocery stores.

“You’re really kicking people when they’re down,” said Lois Lupica, a former attorney working with the Denver-based Community Economic Defense Project and the Debt Collection Lab at Princeton. “They’re basically suing the you-can’t-get-blood-from-a-turnip population.”

In 2022, court records show, Valley View health system based in Glenwood Springs was allowed to garnish the wages of one of its patients over a $400 medical bill. The patient was working at a local organization that the health system supported as part of the community benefits it provides to keep its tax-exempt status. Nonprofit hospitals like Valley View are required to provide community benefits, which can also include charity care that covers patients’ bills.

Stacey Gavrell, the health system’s chief community relations officer, said it offers options such as interest-free payment plans and care at reduced or no cost to families with incomes up to 500% of the federal poverty level.

“As our rural region’s largest healthcare provider, it is imperative to the health and well-being of our community that Valley View remains a financially viable organization,” she said. “Most of our patients work with us to develop a payment plan or pursue financial assistance.”

The collection agency that took the employee to court, A-1 Collection Agency, advertises itself on its website as empathetic: “We understand times are tough and money is tight.”

Pilar Mank, who oversees operations at A-1’s parent company, Healthcare Management, said it accepts payment plans as small as $50 a month and that most of the hospitals it works with allow it to offer a discount if patients pay all at once.

“Suing a patient is the absolute last resort,” she said. “We try everything we can to work with the patient.”

Hospitals sometimes also garnish wages from their own employees for care they provided them. In one case, a hospital employee worked her way up from housekeeper to registrar to quality analyst. She even participated in public events representing her employer and appeared on the hospital’s website as a featured employee — while the court issued writs of garnishment until her $10,000 in medical bills from the hospital was paid off.

“Hospital care costs money to deliver,” said Colorado Hospital Association spokesperson Julie Lonborg about hospitals’ garnishing their own employees’ wages. “In some ways, I think it’s funny to be asked the question. I would understand if someone said, ‘Why aren’t you garnishing their wages?’”

Studies show that hospital debt collection efforts through wage garnishment bring in only about 0.2% of hospital revenues, said April Kuehnhoff, a senior attorney with the National Consumer Law Center, which advocates for people with low incomes.

“We also know that there are states that don’t allow this at all,” she said. “Hospitals are continuing to provide medical care to consumers.”

Smooth sailing for collectors — but not for patients

Health care providers appeared as the plaintiffs in only 2% of the medical debt cases. Instead, cases were filed almost entirely by third-party debt collectors and buyers, with BC Services and Professional Finance Company behind more than half of the cases, followed by A-1 Collection Agency and Wakefield & Associates.

Debt buyers make money by buying debt from providers who’ve given up on getting paid then collecting what they can of the money owed, plus interest. Debt collectors get paid a percentage of what they recover. Some companies do a bit of both.

BC Services declined to comment, and Wakefield & Associates did not respond to questions.

Charlie Shoop, president of Professional Finance Company, said his company initiates wage garnishment on less than 1% of all accounts placed with it for collection.

Health care providers in Colorado can no longer hide behind debt collectors’ names when they sue people, according to a 2024 state law prompted by a 9News-Colorado Sun investigation in partnership with a Colorado News Collaborative-KFF Health News reporting project.

In many states, the path for filing a case against a debtor and garnishing their wages is relatively smooth — especially if the debtor doesn’t appear in court.

“It’s unbelievably easy,” said Dan Vedra, a lawyer in Colorado who often represents consumers in debt cases. “If you have a word processor and a spreadsheet, you can mass-produce thousands of lawsuits in a matter of hours or minutes.”

Within KFF Health News’ sample, nearly all the medical debt cases were default judgments, meaning the patient did not defend themselves in court or in writing. Missing a court date can happen for a variety of reasons, such as not receiving the notice in the mail, assuming it was a scam, knowingly ignoring it, or not having the time to take off from work.

Vedra and other debt law experts said a high rate of default judgments indicates a system that favors the pursuers over the pursued — and increases the chances someone will be harmed by an erroneous bill.

But in New Hampshire, creditors now have to keep going to court for each paycheck they want to garnish, because the state allows creditors to garnish only wages that have already been earned, said Maanasa Kona, an associate research professor at the Center on Health Insurance Reforms at Georgetown University.

“It might not look like much on paper,” she said. “It’s just not worth it if they have to keep going back to court.”

Wrongly pursued for bills

The nation’s medical billing setup is already prone to errors due to its complexity, according to Barak Richman, a law professor at George Washington University and a senior scholar at Stanford Medicine who has studied medical debt collection practices in several states. “Bills are not only noncomprehensible, but often wrong,” Richman said.

Indeed, Colorado’s Health Care Policy & Financing Department, which runs Medicaid in the state, said it sent out nearly 11,000 letters in the past fiscal year to health providers and collectors that erroneously went after patients on Medicaid. Bills for Medicaid recipients are supposed to be sent to Medicaid, not the patients, who typically pay a nominal amount, if anything, for their care.

Shoop said his industry has pushed Colorado, without success, for access to a database that would allow them to confirm if patients had Medicaid coverage.

Colorado’s Medicaid program declined to comment.

Patricia DeHerrera in Rifle, Colorado, had to prove that she and her children had Medicaid when they received care at Grand River Health — but only after A-1 contacted her employer at the time, the gas station chain Kum & Go, with court-approved paperwork to take a portion of her paychecks.

She contacted the state, which sent letters to the hospital and the collector notifying them they were engaging in “illegal billing action” and telling the collector to stop. The companies did.

Theresa Wagenman, controller for Grand River Health, said if a patient can present a letter from a Medicaid caseworker saying they’re eligible, then their bills get removed from the collections pipeline. Wagenman also said patients get at least eight letters in the mail and several phone calls before Grand River gives the go-ahead for the collector to send them to court.

DeHerrera’s main advice to others in this situation: “Know your rights. Otherwise, they’re going to take advantage of you.”

Yet fighting back isn’t easy.

Nicole Silva, who lives in the 900-person town of Sanford in south-central Colorado, said she and her family were all on Medicaid when her daughter was in a car crash. Still, court records show, her wages were garnished for a $2,181.60 ambulance ride, which grew to more than $3,000 from court fees and interest.

She tried to prove the bill was wrong, contacting her county’s social services office, but Silva said it wasn’t helpful and she wasn’t able to reach the right person at a state office. The state Medicaid program confirmed to KFF Health News that her daughter was covered at the time of the wreck.

Fighting the bill felt like too much for Silva and her husband to handle while parenting a growing number of kids, one of them severely disabled, and working — she as a preschool teacher and he as a rancher.

Not receiving the roughly $500 a month that she said came out of her pay was enough to affect their ability to pay other bills. “It was deciding to buy groceries or pay the electric bill,” Silva said.

When their electricity got shut off, she said, they had to scramble to borrow money from colleagues and friends to get it turned back on — with an extra fee.

She said the saga makes her hesitant to call an ambulance in the future.

Fox, of the Colorado Consumer Health Initiative, said consumers often think they cannot do anything to stop their wages from being garnished, but they can contest it in court, for example by pointing out they should have qualified for discounted — or charity — care if the hospital that provided the treatment is a nonprofit.

DeFusco, the economist, believes filing for Chapter 7 bankruptcy is an underused option for debtors. It halts garnishment in its tracks, though not always permanently, and it comes with other consequences. But he understands it’s a Catch-22: It’s a complex process and typically necessitates hiring a lawyer.

“To get rid of your debt, you need money,” he said. “And the whole reason you’re in this situation is because you don’t have money.”

KFF Health News intern Henry Larweh, data editor Holly K. Hacker, Mountain States editor Matt Volz, and web editor Lydia Zuraw contributed to this report.

Methodology

We wanted to know how often Coloradans get their wages garnished due to medical debt. Courts don’t compile this information, and researchers and advocates haven’t tracked it systematically.

So we created our own database. We requested a list of all civil cases across the state in which judges gave permission for a person’s earnings to be garnished — known as writs of garnishment in court lingo — from Feb. 1, 2022, through Feb. 1, 2024. The Colorado Supreme Court Library provided a list from all courts except for Denver County Court, which provided its own records. The combined list comprised nearly 90,000 unique court cases. We split up the cases by county population — small (fewer than 10,000 people), medium (10,000 to 100,000 people), and large (more than 100,000 people) — then generated a random sample of 400 cases from each group to ensure we evaluated medical debt across counties of all sizes.

To identify medical debt cases, we looked at the original creditors named in court records, primarily the complaints or affidavits of indebtedness. Often, this information was available through a state website. When it wasn’t available online, we asked county courthouses to send us supporting documents. We counted dentists as medical providers. We excluded 14 cases in which the debt wasn’t exclusively medical.

We looked only at cases in which courts approved money to be garnished from someone’s paycheck, as opposed to from other sources such as their bank accounts. We did not review garnishment cases involving child support, taxes, or federal student loans.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.

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Stock market today: Dow futures tumble 400 points on Trump’s tariffs over Greenland, Nobel prize

Published

10 hours ago

January 19, 2026

Jace Porter

U.S. stock futures dropped late Monday after global equities sold off as President Donald Trump launches a trade war against NATO allies over his Greenland ambitions.

Futures tied to the Dow Jones industrial average sank 401 points, or 0.81%. S&P 500 futures were down 0.91%, and Nasdaq futures sank 1.13%.

Markets in the U.S. were closed in observance of the Martin Luther King Jr. Day holiday. Earlier, the dollar dropped as the safe haven status of U.S. assets was in doubt, while stocks in Europe and Asia largely retreated.

On Saturday, Trump said Denmark, Norway, Sweden, France, Germany, the United Kingdom, the Netherlands, and Finland will be hit with a 10% tariff starting on Feb. 1 that will rise to 25% on June 1, until a “Deal is reached for the Complete and Total purchase of Greenland.”

The announcement came after those countries sent troops to Greenland last week, ostensibly for training purposes, at the request of Denmark. But late Sunday, a message from Trump to European officials emerged that linked his insistence on taking over Greenland to his failure to be award the Nobel Peace Prize.

The geopolitical impact of Trump’s new tariffs against Europe could jeopardize the trans-Atlantic alliance and threaten Ukraine’s defense against Russia.

But Wall Street analysts were more optimistic on the near-term risk to financial markets, seeing Trump’s move as a negotiating tactic meant to extract concessions.

Michael Brown, senior research strategist at Pepperstone, described the gambit as “escalate to de-escalate” and pointed out that the timing of his tariff announcement ahead of his appearance at the Davos World Economic Forum this week is likely not a coincidence.

“I’ll leave others to question the merits of that approach, and potential longer-run geopolitical fallout from it, but for markets such a scenario likely means some near-term choppiness as headline noise becomes deafening, before a relief rally in due course when another ‘TACO’ moment arrives,” he said in a note on Monday, referring to the “Trump always chickens out” trade.

Similarly, Jonas Goltermann, deputy chief markets economist at Capital Economics, also said “cooler heads will prevail” and downplayed the odds that markets are headed for a repeat of last year’s tariff chaos.

In a note Monday, he said investors have learned to be skeptical about all of Trump’s threats, adding that the U.S. economy remains healthy and markets retain key risk buffers.

“Given their deep economic and financial ties, both the US and Europe have the ability to impose significant pain on each other, but only at great cost to themselves,” Goltermann added. “As such, the more likely outcome, in our view, is that both sides recognize that a major escalation would be a lose-lose proposition, and that compromise eventually prevails. That would be in line with the pattern around most previous Trump-driven diplomatic dramas.”

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Goldman investment banking co-head Kim Posnett on the year ahead, from an IPO ‘mega-cycle’ to another big year for M&A to AI’s ‘horizontal disruption’

Published

13 hours ago

January 19, 2026

Jace Porter

Ahead of the World Economic Forum‘s Annual Meeting in Davos, Switzerland, Fortune connected with Goldman Sachs’ global co-head of investment banking, Kim Posnett, for her outlook on the most urgent issues in business as 2026 gathers steam.

A Fortune Most Powerful Woman, Posnett is one of the bank’s top dealmakers, also serving as vice chair of the Firmwide Client Franchise Committee and is a member of the Management Committee. She was previously the global head of the Technology, Media and Telecommunications, among several other executive roles, including Head of Investment Banking Services and OneGS. She talked to Fortune about how she sees the current business environment and the most significant developments in 2026, in terms of AI, the IPO market and M&A activity. Goldman has been the No. 1 M&A advisory globally for the last 20 years, including in 2025 — and Posnett has been one of the star contributors, advising companies including Amazon, Uber, eBay, Etsy, and X.

Heading into Davos, how would you describe the current environment?

As the global business community converges at Davos, we are seeing powerful catalysts driving M&A and capital markets activity. The foundational drivers that accelerated business activity in the second half of 2025 have continued to improve and remain strong heading into 2026. A constructive macro backdrop — including AI serving as a growth catalyst across sectors and geographies — is fueling CEO and board confidence, and our clients are looking to drive strategic and financing activity focused on scale, growth and innovation. As AI moves from theoretical catalyst to an industrial driver, it is creating a new set of priorities for the boardroom that are top of mind for every client we serve heading into 2026.

What were the most significant AI developments in 2025, and what should we expect in 2026?

2025 was a breakout year for AI where we exited the era of AI experimentation and entered the era of AI industrialization. We witnessed major technical and structural breakthroughs across models, agents, infrastructure and governance. It was only a year ago, in January 2025, when DeepSeek launched its DeepSeek-R1 reasoning model challenging the “moats” of closed-source models by proving that world-class reasoning could be achieved with fully open-source models and radical cost efficiency. That same month, Stargate – a historic $500 billion public-private joint venture including OpenAI, SoftBank and Oracle – signaled the start of the “gigawatt era” of AI infrastructure. Just two months later in March 2025, xAI’s acquisition of X signaled a new strategy where social platforms could function as massive real-time data engines for model training. By year end, we saw massive, near-simultaneous escalation in model capabilities with the launches of OpenAI’s GPT-5.1 Pro, Google’s Gemini 3, and Anthropic’s Claude 4.5, all improving deep thinking and reasoning, pushing the boundaries of multimodality, and setting the standard for autonomous agentic workflows.

In the enterprise, the conversation has matured from “What is AI?” just a few years ago to “How fast can we deploy?” We have moved past the pilot phase into a period of deep structural transformation. For companies around the world, AI is fundamentally reshaping how work gets done. AI is no longer just a feature; it is the foundation of a new kind of productivity and operating leverage. Forward-leaning companies are no longer just using AI for automation; they are building agentic workflows that act as a force multiplier for their most valuable asset: human capital. We are starting to see the first real, measurable returns on investment as firms move from ‘AI-assisted’ tasks to ‘AI-led’ processes, fundamentally shifting the cost and speed of execution across organizations.

Of course, all this progress is not without regulatory and policy complexities. As AI reaches consumer, enterprise and sovereign scale, we are seeing a divergence in global policy that boards must navigate with care. In the United States, recent Executive Orders — such as the January 2025 ‘Removing Barriers’ order and the subsequent ‘Genesis Mission’ — have signaled a decisive shift toward prioritizing American AI dominance by rolling back prior reporting requirements and accelerating infrastructure buildouts. Contrast this with the European Union, where the EU AI Act is now in full effect, imposing strict guardrails on ‘high-risk’ systems and general-purpose models. Meanwhile, the UK has adopted a “pro-innovation” hybrid model: on the one hand, promoting “safety as a service”, while also investing billions into national compute and ‘AI Growth Zones’ to bridge the gap between innovation and public trust. For our clients, the challenge is no longer just regulatory compliance; it is strategic planning and arbitrage – deciding where to build, where to deploy, who to partner with, what to buy and how to maintain a global edge across a fragmented regulatory landscape.

As we enter 2026, the pace of innovation isn’t just accelerating; it is forcing a total rethink of business processes and capital allocation for every global enterprise.

Given the expectation and anticipation for IPOs this year, what is your outlook for the market and how will it be characterized?

We are entering an IPO “mega-cycle” that we expect will be defined by unprecedented deal volume and IPO sizes. Unlike the dot-com wave of the late 1990s, which saw hundreds of small-cap listings, or even the 2020-2021 surge driven by a significant number of billion-dollar IPOs, this next IPO cycle will have greater volume and the largest deals the market has ever seen. It will be characterized by the public debut of institutionally mature titans, as well as totally disruptive, fast moving and capital consumptive innovators. Over the last decade, some companies have stayed private longer and raised unprecedented amounts of private capital, allowing a cohort of businesses to reach valuations and operational scale previously unseen in the private markets. We are no longer talking about “unicorns” — we are talking about global companies with the gravity and scale of Fortune 500 incumbents at the time they go public. For investors, the reopening of the IPO window will enable an opportunity to invest in the most transformative and fastest growing companies in the world and a generational re-weighting of the public indices.

In 2018, the five largest public tech companies were collectively valued at $3.3 trillion, led by Apple at ~$1 trillion. Today, the five largest public tech companies are valued at $18.3 trillion, more than five and half times larger. Even more significant, the 10 largest private tech companies in 2018 were valued at $300 billion. Today, the 10 largest private tech companies are valued at $3 trillion, more than 10 times larger. These are iconic, generational companies with unprecedented private market caps some of which have unprecedented capital needs which should lead to an unprecedented IPO market.

Each of these companies will have their own objectives on IPO timing, size and structure which will influence if, how and when they come to the market, but the potential across the board is significant. During the last IPO wave, Goldman Sachs was at the center of IPO innovation by leading the first direct listings and auction IPOs, and we expect more innovation with this upcoming wave. The current confluence of a constructive macro backdrop and groundbreaking technological advancements is doing more than just reopening the window; it is creating a generational opportunity for investors to participate in the companies that will define the next century of global business.

M&A activity exploded in 2025, are the markers there for another boom year?

As we enter 2026, the global M&A market has transitioned from a year of recovery ($5.1 trillion of M&A volume in 2025, up 44% YoY) to one that is bold and strategic. While the second half of 2025 was defined by a “thawing” — driven by a constructive regulatory environment, fed easing cycle and normalizing valuations — the year ahead will be defined by ambition.

We have entered an era of broad, bold and ambitious strategic dealmaking: transformative, high-conviction transactions where industry leaders are no longer just consolidating for scale, but also moving aggressively to acquire the strategic assets, AI capabilities and digital infrastructure that will define the next decade. CEO and board confidence have reached a multi-year high, underpinned by the realization that in an AI-industrialized economy, standing still is the greatest risk of all. The quality and pace of strategic discussions that we are having with our clients signals that the world’s most influential companies — across sectors and regions — are ready to deploy their balance sheets and public currencies to redraw the competitive map.

AI is no longer an isolated tech trend; it is a horizontal disrupter, broadening the appetite for strategic M&A across every sector of the economy. While the dialogue in boardrooms has moved from theoretical ‘AI pilots’ to large-scale capital deployment, the speed of technology is currently outpacing traditional governance frameworks. Boards and management teams are being asked to make multi-billion dollar, high-stakes decisions in a landscape where historical benchmarks often no longer apply. In this environment, M&A has become a tool for strategic leapfrogging — allowing companies to move both defensively to protect their core and offensively to secure the critical infrastructure and talent needed for non-linear growth. Success in 2026 will be defined by strategic conviction: the ability to turn this unprecedented complexity into a clear, actionable strategy and competitive advantage.

As AI continues to reshape corporate M&A strategy, we are also seeing financial sponsors return to the center of the M&A stage. Sponsor M&A activity accelerated sharply in 2025 — with M&A volumes surging over 50% as the bid-ask spread between buyers and sellers started to narrow, financing markets became more constructive and innovative deal structures enabled private equity firms to pursue larger, more complex transactions. With $1 trillion of global sponsor dry powder and over $4 trillion of unmonetized sponsor portfolio companies, the pressure for capital return to LPs has continued to escalate. Financial sponsors are entering 2026 with a dual-focus: executing take-privates and strategic carveouts to deploy fresh capital, while simultaneously utilizing reopened monetization paths – from IPOs to secondary sales to strategic sales — to satisfy demand for liquidity. With monetization paths reopening and valuation gaps narrowing, sponsors are entering 2026 with greater flexibility, reinforced by a healthier macroeconomic backdrop and improving liquidity conditions.

This Q&A is based on an email conversation with Kim Posnett. This piece has been edited for length and clarity.

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Half of veterans leave their first post-military jobs in less than a year—This CEO aims to fix that

Published

14 hours ago

January 19, 2026

Jace Porter

Taking a career leap can be daunting, but all professionals inevitably have to face the music; most will change jobs or industries at some point, whether they want to or not. But for U.S. veterans exiting service and heading into civilian life, the transition has been especially difficult—and it’s an issue that’s intensifying their unemployment. That’s why financial services titan USAA is putting its money where its mouth is with a $500 million initiative to get members back on their feet.

“What we created here since I took over as CEO is a completely revamped way of hiring our veterans and military spouses,” the company’s CEO, Juan C. Andrade, tells Fortune. “This is not just for the benefit of USAA—this is for the benefit of the military community.”

USAA launched its “Honor Through Action” program in 2025, committing half a billion dollars over the next five years to improve the careers, financial security, and well-being of its customers—many of whom are active military, veterans, or related to them. It’s the brainchild of Andrade, who stepped into the company’s top role in April last year. As someone who also left a longstanding career in the federal government, he understands the growing pains that come with an intimidating career pivot. And for thousands of USAA members, the situation is dire.

Around half of veterans ditch their initial post-military jobs within the first year, according to the Department of Defense’s Transition Assistance Program, and USAA’s CEO believes a lack of thoughtful transition services is largely to blame. When colonels, generals, and sergeants leave behind their high-powered jobs, Andrade says some struggle to adapt both emotionally and skills-wise.

While businesses are required to re-employ former employees who return from military duty per U.S. federal law, those stepping into civilian roles for the first time often need a helping hand. And even before they exit the military, the careers of their partners tend to suffer.

The jobless rate of military spouses has hovered around 22% over the past decade, according to Hiring Our Heroes. That’s more than four times higher than the 4.6% nationwide unemployment rate. When their partners need to relocate for a new duty assignment, spouses are 136% more likely to be unemployed within six months, according to a 2024 Defense Department survey.

This trend of low job retention among veterans and spouse joblessness can be detrimental to the financial and professional livelihoods of American military families. So Andrade is leading the charge to get them on payroll. Corporations like JPMorgan have ramped up ex-military resources, and services like Armed Forces YMCA have long been assisting veterans; But USAA’s CEO says the issue needs a more targeted approach.

“While there’s a lot of organizations that are very well-meaning and do some very good work, the approach has been fragmented,” Andrade explains. “The problem with private sector companies is [if they] have not had that experience of service, or if they don’t have a large population of employees that serve, it’s very difficult to understand the fact that they’ve lost their tribe. The fact that, in a lot of ways, they’ve lost their sense of belonging to something greater than self.”

USAA’s $500 million plan and new fellowship pathways

USAA already has several veteran employment initiatives on the docket this year. This March, the company tells Fortune it will host a nationwide U.S. Chamber of Commerce Foundation program, Hiring our Heroes, in San Antonio to connect on the issue. And in the coming months, USAA will host events with nonprofit and HR association SHRM to brainstorm the best ways to improve military hiring in the U.S.

In stride with Honor Through Action, USAA also launched two 18-month fellowship programs designed to transition military personnel into full-time company positions: Summit and Signal. In three six-month rotations, participants cycle through different parts of the financial services giant to find the best fit. The future leadership track, Summit, rotates fellows through departments including business strategy, operational planning, and product ownership. Starting anew can be isolating, so USAA is ensuring that military personnel are not walking these career paths alone—veterans are connected to mentors every step of the way.

“Those 18 months are incredibly important, because it goes to show you: What is it that you can do? How does a private company actually work? What is it that you do on a daily basis?” Andrade says. “They get one-on-one mentorship and support every step of the way with people that have already walked in their shoes and been successful, so all of that helps.”

And just like what other companies are looking for in white-collar talent, USAA places a special emphasis on AI-savvy workers. That’s where the Signal fellowship comes into play: the pathway targets applicants with tech know-how, cycling them between assignments including technical solutions and data processing. The CEO notes that the military community is teeming with tech skills, and some already come with prior training from U.S. Cyber Command roles. Aside from getting ex-military members back into work, Signal is also proving to be extremely beneficial for the business itself.

“We’re always looking for people who have the expertise and skill sets in data science or data engineering,” Andrade continues. “As they retire from the Air Force, the Army, the Navy, we bring them into a specialized program focused on their skills and how they can help us from technology experience.”

Serving an overlooked population: veteran spouses struggling with joblessness

Even when they’re not deployed, U.S. military personnel are battling wars at home—depression, financial insecurity, and homelessness. But one group is often ignored in the fight: their spouses. The husbands and wives of military personnel face sky-high unemployment rates and long-term instability due to the nature of their partners’ jobs. But Andrade recognizes them as an overlooked and underutilized pool of professionals.

“Military spouses are an incredible source of talent—they’re literally the CFO and the CEO of their home,” USAA’s CEO says. “When their spouses are deployed, when there’s a permanent change of station for their spouse, they have to leave their job. And if they don’t have that flexibility, then you know that’s why the unemployment rate is so high.”

USAA is funneling its resources to get to the root of the issue; as part of the Honor Through Action initiative, the company tells Fortune it will host Military Spouse Advisory Councils in San Antonio this March. The mission is to help shape policy, programs, and resources to better serve the unique needs of military families. That same month, the business also plans to work with other organizations in funding Blue Star Families’ release of Military Spouse Employment Research with the aim of pinpointing actionable solutions to their raging unemployment. And reflecting internally, Andrade reports that USAA will continue to lead by example.

“We can offer a lot of flexibility… Having that level of empathy and understanding becomes very critical,” he says. “This is where we hope—with Honor Through Action—to be able to help companies understand the value that [military spouses] have, but also why you need to treat them a little bit differently given their personal situation.”

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