|79 Million U.S. Adults Have Medical Bill Problems Or Are Paying Off MedicalDebt
The proportion of working-age Americans who have medical
bill problems or who are paying off medical debt climbed from 34
percent to 41 percent between 2005 and 2007, bringing the total to 72
million, according to recent survey findings from The Commonwealth
In addition, 7 million adults age 65 and over also had
problems paying medical bills, for a total of 79 million adults with
medical bill problems or medical debt.
In a new Commonwealth Fund report about the survey findings, Losing Ground: How the Loss of Adequate Health Insurance is Burdening Working Families,
the authors describe how working-age adults are becoming more exposed
to the rising costs of healthcare, either because they have lost
insurance through their jobs or because they are paying more out of
pocket for their healthcare. This combination of factors, along with
sluggish growth in average family incomes, is contributing to problems
with medical bills and cost-related delays in getting needed
The report finds that in 2007, nearly two-thirds of U.S.
adults under age 65, or 116 million people, had medical bill problems
or debt, went without needed care because of cost, were uninsured for a
time, or were underinsured — insured but had high out-of-pocket
medical expenses or deductibles relative to income.
"We are seeing a perfect storm of negative economic
trends threatening working families in the United States," said Sara
Collins, Commonwealth Fund assistant vice president, and the study's
lead author. "While gas and food prices are increasing and home values
are declining, the rise in healthcare costs is surpassing income growth
and fewer people have adequate insurance. As a result, working people
are struggling to pay their bills and accruing medical debt."
While the increase in problems paying medical bills or
carrying unpaid medical bills cuts across income brackets, low and
moderate income families are burdened the most. The report finds that
more than half of working-age adults earning less than $40,000 a year
reported problems paying medical bills or being in debt due to medical
Medical bill problems included not being able to pay
bills, being contacted by a collection agency about an unpaid bill, and
changing one’s way of life in order to pay medical bills.
Those with medical bills and medical debt are
increasingly facing serious financial problems and sometimes facing
trade-offs among immediate life necessities. Thirty-nine percent of
those with bill problems or debt say they have used up all of their
savings to pay their healthcare bills; 29 percent are unable to pay for
basic necessities like food, heat, or rent; and 30 percent took on
credit card debt. Twenty-four percent of adults under age 65 with
medical debt owe $4,000 or more and 12 percent owe $8,000 or more in
unpaid medical expenses.
In a new Commonwealth Fund issue brief which accompanies the report, Seeing Red: The Growing Problem of Medical Debt and Bills,
the authors explain that uninsured and underinsured adults are more at
risk of having medical bill problems and medical debt than those with
adequate insurance coverage. Three in five adults who are uninsured or
underinsured face these challenges, more than double the rate of those
who had adequate insurance all year (26 percent).
Notably, adults 65 years and older were far less likely
to report medical bill problems or debt thanyounger adults because they
are covered by Medicare and may also have supplemental private
coverage, and in the case of low-income individuals, may have Medicaid.
Just 19 percent of adults over 65 — half the rate for adults
under 65 (41 percent) — reported any medical bill problems or
The report also finds that more working-age adults are
delaying or avoiding needed medical care, such as skipping doses of
medication or not filling prescriptions, because of healthcare costs.
Forty-five percent of adults reported problems getting care because of
costs in 2007, a dramatic increase from 29 percent in 2001. Increasing
numbers of adults are spending high proportions of their income on
healthcare. One-third of U.S. working-age adults spent 10 percent or
more of their income on out-of-pocket medical expenses and health
insurance premiums in 2007, up from 21 percent in 2001.
The proportion of Americans who are uninsured continues
to grow. More than one-quarter (28 percent) of U.S. adults ages 19 to
64, or an estimated 50 million people, were uninsured for some time in
2007, compared with 24 percent in 2001.
But even having insurance coverage does not guarantee
protection from medical bill problems and debt. The proportion of those
who are underinsured increased from 9 percent to 14 percent, or 25
million people, between 2003 and 2007.
Sixty-one percent of those with medical bill problems or accumulated medical debt were insured at the time care was provided.
Address: The Commonwealth Fund 1 East 75th Street, New York, NY 10021; (212) 606-3800, www.cmwf.org.