Even Insured Adults Face Growing Burden of Medical Debt

According to a Commonwealth Fund survey released on September 17, roughly 33% of adults aged 19-64 with private health insurance have outstanding medical bills, and almost 50% of those owe $2,000 or more. Senior scholar Sara R. Collins explains that the debt often stems from everyday doctor visits, chronic-condition treatment, and high deductibles that accumulate over time. Interviews with a nationally representative sample of more than 6,300 people and focus-group discussions highlighted surprise at the size of the bills despite having coverage.

The issue may expand as employer-provided benefits become less affordable—projected to rise 8.2% in 2027—and as Congress lets ACA exchange subsidies lapse, pushing consumers into cheaper, lower-quality plans. The report also notes that 30% of respondents reduced spending on food, heat or rent, and 37% used savings to cover medical costs, which can deter future preventive care and harm credit scores. Although fifteen states have limited how medical debt is used in lending, a federal rule protecting borrowers was overturned by a court in July 2025 after the Trump Administration took office.