A complicated and unplanned pregnancy pushed Carlazjion Constant of Smyrna to the brink, financially.

With a high-risk pregnancy, her high-deductible health insurance paid virtually nothing toward the extra obstetrician visits. Just as those bills totaling $5,000 came due earlier this year, a real estate company started garnishing her paycheck as a medical assistant in a pediatric office — over a broken lease from a decade back while she was in college.

“I have a child. Like, I can’t do that,” she says. “I have to do something. Something has to be done. There has to be a way out.”

Medical bills are often what push families into personal bankruptcy, even though they’re rarely a family’s largest debt. But they tend to be unexpected. And nearly one-in-five U.S. households are on the hook for old medical bills, with higher concentrations in the South where most states haven’t expanded Medicaid to cover the working poor.

That’s why Constant, 31, started looking into Chapter 7 bankruptcy, which is intended for those without many assets to protect. Unlike Chapter 13, it essentially cancels most debts, though rarely student loans. She called bankruptcy lawyers and learned they would charge her at least $1,500.

“To get out of debt, I’m going back into debt. It was just wild to me,” she says.

It’s a last resort, but the financial reset button is also out of reach for many because the act of declaring bankruptcy is relatively expensive.

A Brooklyn-based nonprofit called Upsolve is trying to help cut those costs.

More: How one Tennessee court is helping patients avoid complications from medical debt

Constant’s web search for a cheaper resolution led her to the Upsolve site, where users can download an app that helps them file for no charge and without the expense of hiring an attorney.

“Those legal fees are like modern day poll taxes,” says co-founder and CEO Rohan Pavuluri. “I mean, if you can’t pay the fee, you can’t access this right you’re supposed to be guaranteed.”

He calls the app “the Turbo Tax of bankruptcy.” By answering questions in plain language through the app, the user’s financial data related to their debts, income and assets populate into nearly two dozen forms required to file bankruptcy with federal courts.

To offer the service for free, the nonprofit receives some government support as well as money from charitable foundations and some big-time Silicon Valley names, including former Google CEO Eric Schmidt.

Users still owe the $335 court filing fee, though the app also helps users apply to have the fee waived. Since its founding in 2018, Upsolve says it has relieved more than $435 million in debt.

More than simplifying the process, Pavuluri says he’s on a mission to destigmatize bankruptcy. He says it’s seen as a moral failure even though bankruptcy is frequently used strategically in the corporate world to get a fresh start.

“We want to empower everyday Americans to get the same tools that the richest people and the richest corporations in America have,” he says.

But there are concerns — and not just from bankruptcy attorneys — about making bankruptcy a little too accessible. There is some value in the guidance attorneys give, says Tennessee bankruptcy lawyer Cynthia Podis.

“The medical debts you have right now might just be the tip of the iceberg,” she says, giving the case of a client who is feeling the pressure of $20,000 in overdue medical bills for an initial round of chemotherapy. “But you know that over the next four or five years, you’re going to have $150,000 worth of cancer treatment. You may not want to file a Chapter 7 right now.”

Chapter 7 is a lifeline that can only be used once every eight years. So if debt continues to accrue, it won’t be an option again for a while.

Bankruptcy also devastates credit for years, making it difficult to qualify for a conventional car loan or an apartment lease.

More: Tennessee study finds medical debt is surprisingly common

Erin Akery, who provides free financial counseling with the United Way in Nashville, says bankruptcy isn’t right for everyone. And the cost, while sometimes prohibitive, also helps those saddled with debt consider the tradeoffs with Chapter 7.

“That may not be so great for people who are looking for a quick, easy solution, and it’s not the right path for them,” she says. “I think if people don’t have to go through that cost-benefit analysis, then a lot more people might file bankruptcy who really shouldn’t.”

But the need is great, and expected to grow in the aftermath of COVID-19 with a disproportionate impact on Black Americans. Upsolve’s own data shows half of its African American users now cite the pandemic as the primary reason for filing.

And medical debt is becoming a larger share of personal debt. Upsolve found the average user had about $7,000 in medical debt before the pandemic, and a year into the pandemic the figure had more than doubled.

Even financial counselors like Akery, who consider Chapter 7 the “nuclear option,” say it can be a useful tool.

“I think that stigma keeps a lot of people from doing it who really could benefit from it and come out the other side with a more healthy financial future,” she says. “But on the flip side, there are people who file for bankruptcy every eight years.”