Health Care Debt In The U.S.: The Broad Consequences Of Medical And Dental Bills

This KFF Health Care Debt Survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation (KFF) in collaboration with KHN journalists and editors. The survey was conducted February 25 through March 20, 2022 online and via telephone, in English and Spanish, among a nationally representative sample of 2,375 U.S. adults. The sample includes 1,674 adults with current or past health care debt and 698 adults who have not had health care debt in the past five years. The majority of respondents (n=2,146) were reached online through the SSRS Opinion Panel. The SSRS Opinion Panel is a nationally representative probability-based web panel recruited randomly in one of two ways: (a) Through invitations mailed to respondents randomly sampled from an Address-Based Sample (ABS). ABS respondents are randomly sampled through the U.S. Postal Service’s Computerized Delivery Sequence (CDS). (b) from a dual-frame random digit dial (RDD) sample, through the SSRS Omnibus survey platform. To ensure representation of respondents less likely to be reached online, 177 interviews were conducted from a random digit dial telephone sample of prepaid cell phone numbers. Both the RDD sample for the SSRS Omnibus and the prepaid cell phone numbers were obtained through Marketing System Groups (MSG).

The survey was designed to reach adults who currently have health care debt or have had health care debt in the last five years. In order to do this, the probability panel sample included an oversample of panel members with annual household incomes less than $30,000, individuals with current or past health care debt (n=641) were included in the sample. In addition, 52 adults with past or current health care debt were reached by calling back respondents that had previously completed an interview on the SSRS Omnibus poll (and other RDD polls) and reported an annual household income of less than $25,000.

The combined online and telephone samples, excluding oversamples, were weighted to match the sample’s demographics to the U.S. population using data from the Census Bureau’s 2021 Current Population Survey (CPS). On the basis of this weighted sample, parameters for the debt and no-debt populations were extracted. Weighting parameters for each group included sex, age, education, race/ethnicity, region, education, and income, as well as patterns of civic engagement from the September 2017 Volunteering and Civic Life Supplement data from the CPS. The sample was also weighted to match population density parameters from the Census Planning Database 2020. The weights take into account differences in the probability of selection for each sample type. This includes adjustment for the sample design and geographic stratification of the cell phone sample, within household probability of selection, and the design of the panel-recruitment procedure.

The margin of sampling error including the design effect for the full sample is plus or minus 3 percentage points. Numbers of respondents and margins of sampling error for key subgroups are shown in the table below. For results based on other subgroups, the margin of sampling error may be higher. Sample sizes and margins of sampling error for other subgroups are available by request. Sampling error is only one of many potential sources of error and there may be other unmeasured error in this or any other public opinion poll. Kaiser Family Foundation public opinion and survey research is a charter member of the Transparency Initiative of the American Association for Public Opinion Research.

Group	N (unweighted)	M.O.S.E.
Total	2,375	± 3 percentage points
Health Care Debt Status
NET: Current or past health care debt	1,674	± 3 percentage points
Current health care debt	1,292	± 3 percentage points
Past health care debt	382	± 6 percentage points
No health care debt	698	± 5 percentage points