But even having health insurance is not guaranteed to keep people out of financial ruin.
“Medical-debt issues often stem from routine care, including doctor’s office visits and treatment for chronic conditions,” says Sara R. Collins, a senior scholar at the Commonwealth Fund and one of the authors of the report. High deductibles are another common source. “People are just dealing with routine care and bills that build up over time.”
The problem of insured Americans with medical debt could grow in the coming years as health insurance becomes less affordable. Already, the cost of health benefits per employee is projected to rise 8.2% in 2027, the highest increase since 2003, according to an August survey by Marsh, and some employers may downgrade their plans and shift more costs to employees, employers told Marsh. What’s more, after Congress decided not to renew subsidies for people buying health insurance from Affordable Care Act Exchanges, many consumers switched to lower quality plans that will cost them more if they have catastrophic or chronic health issues, according to April data from the Center on Budget and Policy Priorities.
Once people experience medical debt, they often hesitate to seek out more medical care, says Collins. That can lead to higher expenses for everyone in the long run, as they end up needing emergency services instead of less expensive preventative care.
Fifteen states have passed various laws limiting the use of medical debt in lending decisions and on credit reports. The Consumer Financial Protection Bureau had finalized a federal rule designed to keep medical debt off credit reports and out of credit decisions, but a federal court vacated the rule in July 2025 after the Trump Administration took office.
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