At a Glance | December 15, 2022 One in Five Americans Struggle With Past-Due Medical Bills, Which Can Have a Cascading Effect on Their Health UNPAID MEDICAL BILLS Percentage of Americans Reporting Past-Due Medical Bills, 2012–2021 The percentage of Americans aged 18–64 who report past-due 26% medical bills from a health care 23% 22% 18% or medical service provider has 21% Reduction in Americans remained in the low 20 percent Reporting Overdue range since 2015. Although levels Medical Bills Since 2012 of medical debt have decreased since 2012, the potential for adverse effects as a result of that 2012 2015 2018 2021 debt remains. INSURANCE + MEDICAID IMPACT Percentage of Americans Reporting Past-Due Medical Bills, by Health Insurance and Medicaid Coverage Status, 2021 Among individuals with health insurance, a quarter reported they had past-due medical bills. 24% 35% In contrast, over a third of of Individuals With of Individuals Without individuals who were uninsured Health Insurance Health Insurance Report Debt Report Debt had past-due medical bills. We also find that individuals residing in Medicaid-expansion states were less likely than those residing in states that did 20% 27% not expand Medicaid to report of Individuals Living of Individuals Not Living in a Medicaid-Expansion in a Medicaid-Expansion past-due medical bills. State Report Debt State Report Debt FORGOING CARE? Reported Health Care Usage Among Individuals With Past-Due Medical Bills, 2021 Past-due medical bills were Health Care Service Yes, Delayed Care No Delay highly correlated with lower usage of health care services. Did Not Fill a Prescription 58% Among individuals who reported Because of the Cost that they had past-due medical bills, the majority reported that Skipped Medical Test, Treatment, 56% they had not filled a prescription, or Follow-Up Recommended by a Doctor Due to Cost that they skipped a medical test or treatment, or that they Had a Medical Problem but 54% did not go to the doctor for a Did Not Go to a Doctor or Clinic medical problem due to the cost. Because of the Cost This study was supported by a grant from the FINRA Investor Education Foundation. The study was conducted through the EBRI Center for Research on Health Benefits Innovation (EBRI CRHBI), which receives funding support from the following organizations: Aon, Blue Cross Blue Shield Association, FINRA Investor Education Foundation, ICUBA, JP Morgan Chase, Pfizer, and PhRMA. SOURCE: Fronstin, Paul, and Jake Spiegel, “Bitter Pill: A Demographic Analysis of Unpaid Medical Bills,” EBRI Issue Brief, no. 568 (September 1, 2022). © 2022 EBRI This report is copyrighted by the Employee Benefit Research Institute (EBRI). You may copy, print, or download this report solely for personal and noncommercial use, provided that all hard copies retain any and all copyright and other applicable notices contained therein, and you may cite or quote small portions of the report, provided that you do so verbatim and with proper citation. Any use beyond the scope of the foregoing requires EBRI’s prior express permission. For permissions, please contact EBRI at permissions@ebri.org.