The New York Times reports on new research revealing that medical debt is far greater in the US than originally thought. The amount of medical debt is particularly high in states that refused to expand Medicaid.
The JAMA study reveals that, pre-pandemic, collection agencies held $140 billion in medical debt. More than one in six Americans owe money for health care services to collection agencies. On top of that, millions more Americans owe money to health care providers, which has not been sent for collection yet.
While people hold all kinds of debt, medical debt represents the largest portion of debt that Americans hold. Because so many Americans are either uninsured or functionally uninsured–insured but unable to pay the deductibles and copays to access needed care–medical debt is to be expected.
Hospitals increasingly sue patients to collect the huge out-of-pocket costs virtually every American must pay. The lawsuits lead to additional costs, such as legal fees. And, credit card payments often lead to large interest payments.
In states that have expanded access to Medicaid, fewer people with low incomes have medical debt. Overall they owe $375 less than people in states that have not expanded Medicaid. Medicaid tends to reduce or wipe out medical bills that could lead to debt.
Senators Raphael Warnock, Jon Ossoff and Tammy Baldwin have introduced legislation that would permit federal expansion of Medicaid in all 12 states that have not expanded it. While this would help millions of people, it would also give more money and power to the health insurance industry, which would see its business expand significantly.
Rising medical debt offers another compelling argument for Medicare for all. Good health insurance both promotes access to health care and provides economic security. Lack of good health insurance can keep people in medical debt their entire lives, hurting people’s credit ratings and causing profound stress. Too bad Congress does not tend to respond to compelling arguments.
Here’s more from Just Care:
- Social Security benefits need to increase
- Medicare drug benefit leaves many with high out-of-pocket costs
- $150,000: Your health care costs in retirement
- Costs in Medicare Advantage present barrier to care
- The deadly consequences of out-of-pocket drug costs

