Nikiesha Barnett had knee surgery in 2006 and took unpaid leave from her job as a Georgia hospital coordinator while she was recovering. When Barnett wasn’t able to keep up with the payments for the surgery, she ended up owing about $4,500. That debt lingered for almost 14 years until one day in 2020, she received a letter from a nonprofit telling her the debt had been relieved. Barnett is one of millions of Americans who’ve had medical debt paid by nonprofits that receive increased support from a wide variety of grantmakers and donors, including MacKenzie Scott.