Published: February 29, 2022
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According to the Federal Reserve, U.S. household debt reached over $15 trillion in 2021, an astronomical number fueled by student loans, mortgages, credit cards, and other forms of borrowing.
Given the high cost of healthcare in the U.S., it’s unsurprising that some of this household debt can be attributed to medical expenses. In February 2022, AffordableHealthInsurance.com surveyed 1,250 American adults, finding that 56% of them have medical debt, a circumstance that has ripple effects on many other aspects of their lives.
Overall, more than half of Americans 18 and older, 56%, have at least some medical debt.
Among these individuals, 55% owe between $501 and $10,000.
However, nearly one-fourth of Americans with medical debt, 23%, owe more than $10,000. Six percent report owing between $50,001 and $100,000, and 5% owe more than $100,000.
The majority of Americans with medical debt, 59%, incurred medical debt with their own healthcare, while 29% say their medical debt includes expenses for dependents.
Regardless of how much they owe, or how the debt was incurred, 32% of Americans with medical debt say it’s ‘unlikely’ or ‘very unlikely’ that they will be able to pay off their medical bills in their lifetime.
Insured and uninsured Americans both report having medical debt at similar rates.
Fifty-nine percent of uninsured individuals have medical debt, compared to 56% of those with insurance.
When broken down by type of insurance, those with employer-provided health insurance or health insurance purchased through a marketplace are most likely to have medical debt.
Sixty-nine percent of Americans who have health insurance purchased through a marketplace have medical debt, as do 61% of Americans with employer-provided health insurance. Meanwhile, 47% of Americans who are covered by Medicare or Medicaid have medical debt.
Knowledge gaps could be contributing to higher-than-necessary out-of-pocket costs for insured individuals, according to healthcare advisor Dr. Noor Ali.
“I speak to many people everyday who are seeking health insurance but don’t know the difference between premiums and deductibles,” Ali says. “These gaps in knowledge and information naturally roll over to usage, and perhaps misuse of health policies. Having more education about proper utilization of health insurance policies and knowing when to go to urgent care versus emergency room can help patients avoid significant costs.”
The number one source of medical debt is emergency room visits, with 44% of respondents selecting this answer as a contributor to their unpaid medical bills.
According to Ali, this is largely due to differences in how emergency room care is delivered versus care in other types of settings.
“To rule out many dire medical diagnoses, a certain level of work up and testing must be performed in an emergency room setting,” she says. “Moreover, services done in an emergency room are often billed at a higher rate to insurance simply due to the high-tech equipment and time-sensitive nature of the tests. This rolls over into higher patient responsibility and more medical debt.”
To avoid the high cost of emergency room care, Noor recommends a different sequence of treatment, if possible.
“If possible, emergencies should first be dealt with via a tele-medicine appointment, then an in-office doctor visit, then an urgent care facility. Emergency room visits should be a last resort,” Ali says.
Other top sources of medical debt are hospitalization (36%), specialist doctors and care (30%), and diagnostic tests (30%).
In most cases, there isn’t much divergence between insured and uninsured respondents regarding the sources of their medical debt.
However, 25% of uninsured individuals say pregnancy contributed to their medical debt, compared to 16% of insured individuals. Similarly, 25% of uninsured respondents report incurring medical debt from vision and dental care, compared to 18% of those with insurance.
While most sources of medical debt are familiar, the COVID-19 pandemic has been a more recent contributor. Thirty percent of respondents with medical debt incurred debt from COVID-19 treatment, including testing, inpatient care, or outpatient treatments for the virus.
Americans with health insurance are more likely than those without to say they incurred medical debt from COVID treatment, by a rate of 31% to 22%. However, research shows that individuals without health insurance were less likely to seek treatment in the first place if they contracted COVID-19.
While 27% of Americans with medical debt say this debt isn’t preventing them from making any purchases or big life moves, for the other 73%, it’s having serious implications.
Forty-six percent of Americans with medical debt say it’s preventing them from buying a home, while 43% can’t save for retirement while trying to pay off their medical bills.
Twenty-six percent of respondents with medical debt are finding themselves in a cycle of financial hardship, in which they can’t get a job due to background and credit checks that reveal their debt.
Others are putting off major life events, such as getting married (24%) and having children (22%).
Americans with medical debt are coping with it in a variety of ways, including, in some cases, not dealing with it at all.
Seventeen percent of respondents with medical bills aren’t currently paying off their debt.
Among those who are trying to pay back their medical debt, 43% are on a payment plan, while 25% are negotiating with their health insurance companies to get their debt reduced or erased.
These are two critical approaches to dealing with medical debt, Ali says.
“If you find yourself with medical debt, it’s always a good idea to speak to the department that is sending you bills,” she says. “See if there is a way to negotiate the bill down to a more manageable amount. Most larger facilities also have a financial hardship department that can help set up a payment plan to make paying off the debt easier.”
Twenty-three percent are trading one type of debt for another, paying medical bills with credit cards. Meanwhile, 21% are borrowing money from family and friends. One in 5 individuals with medical debt are trying to pay it off by working multiple jobs, while 14% are considering declaring bankruptcy this year.
For 44% of respondents with medical debt, their debt is currently being handled by a collections agency.
All data found within this report derives from a survey commissioned by AffordableHealthInsurance.com and conducted online by survey platform Pollfish. In total, 1,250 American adults ages 18 and older were surveyed. This survey was conducted over a two-day span, starting on February 18, 2022 and ending February 19, 2022. All respondents were asked to answer all questions truthfully and to the best of their abilities. For full survey data, please email Content Marketing Specialist Kristen Scatton at [email protected].