Figure 2 Past-Due Medical Bills, Individuals Ages 18 –64, by Health Insurance The study also found that: Status, 2021 • Compared with other sources of debt, Americans were less likely to have past-due medical bills. 40% • Women were slightly more likely than men to report past-due medical bills. November 10, 2022, #444 • The likelihood of having past-du 35% e medical bills increased with age for younger adults but decreased with 35% age for older adults. • Black adults were more likely than other race/ethnicity groups to report past-due medical bills. 30% 27% • Adults with no more than a high school diploma were likelier than those with a college or graduate degree Who Has Past-Due Medical Bills to report past-due medical bills. 24% 25% and What Are the Impacts? • As income increased, the odds of having past-due medical bills decreased. 20% • Individuals with past-due medical bills were more likely than those without past-due medical bills to 20% With cost sh repoaring rt several in employment other financi -based al challeng healthes. plans on the rise, participating workers often pay more out of po cket for health care services than they did in the past. Despite this increase in cost sharing, however, a recent 15% EBRI study found that the percentage of Americans who report past-due medical bills has remained in the low 20 Although levels of medical debt are often low, the potential for adverse effects resulting from that debt remains a con percent cern. M rang edical d e since 2 ebt 01 on 5, d credit own rep from 26 orts can affect o percent in 2 ne’ 012. s abil The stu ity to:dy u sed data from the FINRA Investor 10% Education Foundation’s 2012–2021 National Financial Capability Survey (NFCS). • Obtain a mortgage. 5% • Get a lease for an apartment. • Get insurance. 0% Has Health Insurance Uninsured Resides in Medicaid Does Not Reside in • Get a job. Figure 1 Expansion State Medicaid Expansion State • Obtain other forms of Health cred Insura it. nce Status Past-Due Medical Bills, Individuals Ages 18 and Older, 2012 –2021 Medicaid Expansion State 30% Medical debt may also affect credit worthiness, which in turn affects the interest rate that a consumer can get on a Source: Employee Benefit Research Institute (EBRI) estimates from the 2021 National Financial Capability Survey (NFCS). 26% loan. Medical debt may also lead to delay or avoidance of health care, which can result in not just higher health 25% care costs in the long term, but also worse health outcomes. Beginning in July 2022, the three major credit 23% Past-due medical bills were highly correlated with lower usage of health care services. Among individuals who 22% reporting bureaus began phasing in changes to the way medical debt is included in credit reports to address some 21% reported past-due medical bills, 58 percent indicated that they had not filled a prescription because of the cost; 56 of these adverse effects. percent reported that they skipped a medical test, treatment, or follow-up recommended by a doctor; and 54 20% percent reported that they did not go to the doctor for a medical problem because of the cost. About EBRI: The Employee Benefit Research Institute is a private, nonpartisan, and nonprofit research institute based in Wash 15% ington, D.C., that focuses on health, savings, retirement, and economic security issues. EBRI does Figure 3 not lobby and does not take policy positions. The work of EBRI is made possible by funding from its members Past-Due Medical Bills, Individuals Ages 18 –64, and sponsors, which include a broad range of public and private organizations. For more information, visit by Use of Health Care Services, 2021 10% www.ebri. 70 or %g. Did Not Fill Prescription Because of the Cost A Thank You To Our Funders: This study was supported by a grant from the FINRA Investor Education 60% 58% Skipped Medical Test, Treatment or Follow-Up Recommended by 5% 56% Foundation. The study was conducted through the EBRI Center for Research on Health Benefits Innovation a Doctor Because of the Cost 54% (EBRI CRHBI), which receives funding support from the following organizations: Aon, Blue Cross Blue Shield Had a Medical Problem but Did Not Go to a Doctor or Clinic 50% Because of the Cost Association, FINRA Investor Education Foundation, ICUBA, JP Morgan Chase, Pfizer, and PhRMA. Any views 0% 2012 2015 2018 2021 expressed in this report are those of the authors and should not be ascribed to the officers, trustees, or other sponsors of EBRI, EBRI-ERF, or their staffs. Source: Employee Benefit Research Institute (EBRI) estimates from the 2012-2021 National Financial Capability Survey (NFCS). 40% FINRA Investor Education Foundation 30% The FINRA Investor Education Foundation, established in 2003 by the Financial Industry Regulatory Authority, 20% 20% 19% 19% Inc., empowers underserved Americans with the knowledg 18% e, skills, and tools to make sound financial decisions 20% 17% Among individuals with health insurance, one-quarter (24 percent) reported past-due medical bills, compared with throughout life. For details, visit www.FINRAFoundation.org. 35 percent of uninsured individuals. Further, individuals residing in Medicaid expansion states were less likely 10% than those residing in states that did not expand Medicaid to report past-due medical bills (20 percent vs. 27 percent, respectively). 0% Yes No Don't Know, Prefer Not To Say ### Source: Employee Benefit Research Institute (EBRI) estimates from the 2021 National Financial Capability Survey (NFCS). EBRI’s on Twitter! @EBRI or http://twitter.com/EBRI EBRI blog: https://ebriorg.wordpress.com/ E EBRI BRI o on n T Tw wi it tt ter: er: @ @E EBRI BRI o or r h ht tt tp p: :/ // /t tw wi it tt ter er.com .com/ /E EB BRI RI Bl Blo og g: : h ht tt tp ps s: :/ // /e eb br ri io org rg..w wo ord rdp pre res ss s.c .co om m/ / © 2022, Employee Benefit Research Institute, 901 D St. SW, Suite 802, Washington, DC 20024, 202/659-0670 www.ebri.org 3 2