A report released by the Commonwealth Fund on Thursday found that one-third of Americans with health insurance carry medical debt that they are paying off over time. The analysis focused on individuals who obtain coverage through their employers, the Affordable Care Act marketplace, or the private insurance market.
The study identified hospital visits as the primary source of this debt, affecting nearly two-thirds of adults with medical liabilities. Other reported sources of debt include routine medical care such as doctor's office visits, laboratory work, and diagnostic tests. Sara Collins, the study's lead author and a health economist at the Commonwealth Fund, stated that the debt is primarily driven by the limitations of insurance coverage regarding out-of-pocket costs.
According to the survey, approximately 15% of all working-age, privately insured adults—representing nearly half of those with medical debt—owe $2,000 or more. To manage these expenses, 37% of respondents with medical debt reported using their savings, and 30% reported reducing spending on basic needs such as food, heat, or rent. Additionally, 30% of participants with medical debt said they delayed or skipped necessary medical care due to the cost.
The findings were gathered through telephone and online surveys of a nationally representative sample of 6,353 adults. Collins noted that medical bills often disrupt household budgets for individuals who have little discretionary income. The report suggests that consumers check bills for erroneous charges and contact insurers or providers to negotiate payment plans or dispute denied coverage.
The concrete day-to-day change for these individuals involves a choice between paying medical collectors and maintaining basic standards of living. According to the data, three out of every ten people with this debt are choosing to forgo further medical treatment or reduce their intake of food and heat to manage these costs. This indicates that having insurance does not necessarily protect a household from significant financial shifts or the inability to afford future healthcare services.
The knock-on effects include potential impacts on the broader economy as consumer spending is diverted from retail or savings into medical debt repayment. Furthermore, the practice of forgoing care to avoid additional debt could lead to more significant health issues and higher costs for the healthcare system in the long term. While the report suggests that consumers can dispute errors or negotiate payment plans, it does not specify a date for new legislative or regulatory changes to address these out-of-pocket costs. What happens next depends on individual negotiations between patients and providers, as no specific government deadlines or upcoming votes were reported.