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Hospitals Owed Majority of Patients' Outstanding Medical Debt

Analysis  |  By Amanda Schiavo  
   March 21, 2023

The analysis found that most adults with past-due medical debt owed at least $1,000, and more than one in five owed at least $5,000.

Medical debt is a predominant problem in the United States, with many patients choosing to forego care rather than take on this massive financial burden. But those who do seek care often end up with outstanding bills they struggle to pay.

Indeed, 15% of nonelderly adults in the U.S. reported having past-due medical bills, according to analysis from the Urban Institute, with support from the Robert Wood Johnson Foundation. Of those with outstanding debt, 73% say they owe some or all of it to hospitals. The research focused on adults with family incomes below and above 250% of the federal poverty level and found that 15.4% of adults live in families with past-due medical debt. About two-thirds of these adults have incomes below 250% of the federal poverty level.

"The persistence of medical debt highlights the ongoing challenges families face in obtaining affordable healthcare, including high prices for services, gaps in access to health insurance coverage, and inadequate protection against out-of-pocket costs for many people with high-deductible insurance plans," the report says. "The concentration of past-due medical debt among families with low incomes and the large share who owe a portion of that debt to hospitals suggests that expanded access to hospital charity care and stronger consumer protections could complement coverage expansions and other efforts to mitigate the impact of unaffordable medical bills."

The analysis found that most adults with past-due medical debt owed at least $1,000, and more than one in five owed at least $5,000. Adults with past-due hospital bills were more likely to have much higher total amounts of medical debt than adults with only debt from non-hospital providers. 

"High rates of medical debt underscore the challenges millions of families and adults—especially families and adults struggling to make ends meet—face trying to pay their medical bills," Gina Hijjawi, senior program officer at the Robert Wood Johnson Foundation said in a release. "We see that individuals with disabilities, and Black and Latino adults are disproportionately represented among adults carrying past-due medical debt. Consumers need standards in place that protect them from undue medical debt and help them obtain affordable care."

Amanda Schiavo is the Finance Editor for HealthLeaders.

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