The Burden of Medical Debt: Results from the Kaiser Family Foundation/New York Times Medical Bills Survey

Conclusion

These survey findings confirm that problems related to unaffordable medical bills and medical debt are prevalent, affecting roughly 1 in 4 non-elderly adults in the United States. Certain groups are more vulnerable, including individuals and families with lower incomes and limited financial assets, people with chronic medical conditions and disabilities, the uninsured, and people insured by plans with high deductibles.  Even so, people are not immune who have higher incomes, who are insured, or who are otherwise in good health and then experience unexpected health problems.

Insurance features like cost-sharing, provider networks, and confusing billing practices can all lead to medical bill problems among the insured. While higher deductibles and other forms of cost-sharing have helped to keep health insurance premium growth at historically low levels in recent years, the survey highlights the consequences these changes can have for people. Price transparency is another issue; while many say they tried to research treatment option costs in advance, most say such information was difficult to find.

The survey also shows that medical bill problems can have real and often lasting impacts on individuals and families in terms of their standard of living, their financial stability, and their ability to access needed health care. While insurance provides some protection against incurring medical bill problems in the first place, once these problems occur, the effects on individuals and families are often as serious for the insured as they are for the uninsured. As the nation moves beyond the debate over the Affordable Care Act, issues of health care costs and affordability like those highlighted by this survey are likely to play a prominent role in health policy discussions. Information about the causes of medical debt and its impacts on people can play an important part in these discussions and help policymakers and others as they work on solutions to alleviate the burden of medical debt on American families.

Section 4: Patients as Consumers Appendix 1: Reported Problems Paying Medical Bills By Demographic Group