Medical debt can even crush the insured

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By Denise Mann
Health Day Reporter

MONDAY, September 19, 2022 (HealthDay News) — Weeks after a hospital stay, your bill arrives and you can’t believe the amount owed. How is that even possible when you have good health insurance and most importantly how are you going to pay for it?

Unfortunately you are not alone. According to a new study, more than one in 10 American adults and nearly one in five US households have medical debt. To make matters worse, medical debt more than doubles your chances of not being able to afford groceries, rent, a mortgage, or utilities and losing your home.

“Medical debt is incredibly common and toxic,” said study author Dr. Steffie Woolhandler. She is a family doctor and distinguished professor at Hunter College in New York City.

It’s a vicious cycle, said Woolhandler, also an associate professor of medicine at Harvard Medical School in Boston and a research associate at Public Citizen’s Health Research Group, a nonprofit consumer organization.

“People get sick and they go on medical debt, and that leads to food insecurity and housing insecurity, which makes them even sicker, so they need more medical care and they end up in even more medical debt,” she said.

The bottom line? “They get sicker and poorer and sicker and poorer,” Woolhandler explained.

For the study, the researchers analyzed data from the US Census Bureau’s 2018, 2019, and 2020 income and program participation surveys for a group of people who participated every three years. They used this data to isolate the effects of medical debt.

The average amount of medical debt was about $2,000 for an adult and about $4,600 per US household, the study showed.

Sickness debt was common, even among policyholders.

“There have been other reports of medical debt, but this is the first time we’ve actually been able to link it to outcomes like starvation and homelessness,” Woolhandler said.

Middle-class Americans were just as likely as low-income people to have medical debt. People with military health insurance had the lowest rate of medical debt at just under 7%, the study found.

People at highest risk of new medical debt were those who were newly disabled, hospitalized, or lost their health insurance, the researchers reported.

It’s time to fix this mess, and it’s possible, Woolhandler said.

“Polls show that the majority of Americans would support a system where the government pays all medical bills,” she said.

The recent No Surprises Act has helped make things a little better. This law went into effect in January and protects policyholders from receiving unexpected medical bills due to unexpected off-the-grid health insurance.

There are other things you can do to reduce your risk of crippling medical debt, she said. “If you go to the hospital and you get a bill you can’t pay, try to negotiate,” she said. “You’re in much better shape talking to the hospital than you are talking to a collection agency.”

Many hospitals also have financial assistance programs, she said. Always go through all medical bills and make sure they’re accurate, she suggested.

The results were published online on September 16th JAMA network open .

Allison Sesso is President and CEO of RIP Medical Debt, a national non-profit organization based in Long Island City, NY dedicated to helping people get out of medical debt.

“Medical debt is not just a sign of creditworthiness. We know it prevents patients from seeking further treatment or they are denied treatment,” said Sesso, who has no ties to the new study.

“Medical debt doesn’t just affect the uninsured: people with health insurance are at risk of medical debt because of the high cost of their own,” she added.

Why? The average annual deductible for employer-financed insurance has grown steadily. “Ensuring people have access to affordable, robust, low-deductible health insurance plans is the best way to close the health coverage gap,” Sesso said.

Implementing the Medicaid expansion — which would cover more low-income Americans — in holdout states is an immediate way to help millions of people avoid medical debt, she added. And financial help needs to be very accessible when people see a doctor or go to the hospital.

“We’d like to see a ban on extraordinary debt collection practices like lawsuits, wage garnishments and home liens for people who just can’t pay an astronomical medical debt,” Sesso said.

More information

RIP Medical Debt offers tips on avoiding medical debt.

SOURCES: Steffie Woolhandler, MD, MPH, Family Physician, Distinguished Professor, CUNY’s Hunter College, New York City, Lecturer, Medicine, Harvard Medical School, Boston, Research Fellow, Public Citizen Health Research Group; Allison Sesso, President and CEO, RIP Medical Debt, Long Island City, NY; JAMA Network Operan, 09/16/2022, online


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Medical debt can even crush the insured
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