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

Introduction

The cost of health care has long been a concern in the U.S., on both a national and a personal level. For individuals, this concern plays out most prominently among those who face difficulty paying medical bills or who are unable to pay such bills at all. For people who are uninsured, lack of coverage not only hinders access to care but also leaves them vulnerable to medical bills that cannot be paid. While insurance provides financial protection, that protection can be incomplete for a number of reasons, including rising deductibles and other forms of cost-sharing, out-of-network charges, the growing complexity of insurance that can leave consumers with unexpected bills, and the fact that many people have only modest financial assets to cover medical expenses.

Previous Kaiser surveys have found that about a quarter of people say they or someone in their household had problems paying medical bills in the past year, and a 2014 Kaiser report provided a qualitative look at some of the circumstances and consequences of unpaid medical bills through interviews with people who had sought credit counseling for medical debt.1 But to date, there has been little research providing a quantitative look at the causes of medical bill problems and the impacts they have on people’s families, their finances, and their access to health care.

To fill this gap, the Kaiser Family Foundation and The New York Times conducted an in-depth survey with 1,204 adults ages 18-642 who report that they or someone in their household had problems paying or an inability to pay medical bills in the previous 12 months. To provide context, we also conducted a shorter companion survey with 1,371 adults ages 18-64 who do not report having medical bill problems.

Overview Section 1: Who Has Medical Bill Problems and What Are the Contributing Factors?

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