Among the key findings of the study:

Medicaid expansion under the Affordable Care Act was associated with reduced medical debt overall and with reduced gaps in the amount of medical debt between low- and high-income communities.
During the last decade, medical debt has become the largest source of debt in collections. The reductions in nonmedical debt in collections between 2009 and 2020 occurred simultaneously with the economic recovery from the recession, consistent with the well-documented association between unemployment and loan delinquency.
By contrast, total medical debt in collections decreased by a more modest amount. As a result, as of June 2020, individuals had $39 more in mean medical debt in collections than they had in mean debt in collections from all other sources combined ($429 vs. $390), including credit cards, utilities and phone bills.
Researchers estimate that total medical debt in the United States is $140 billion.
Many states with the highest pre-ACA levels of medical debt did not expand Medicaid and subsequently did not experience substantial reductions in medical debt. Specifically, eight of the 12 states that did not expand Medicaid are in the South, the region with the highest pre-ACA levels of medical debt.

"This study provides an estimate of the amount of medical debt in collections in the United States based on consumer credit reports from January 2009 to June 2020, reflecting care delivered prior to the COVID-19 pandemic, and suggests that the amount of medical debt was highest among individuals living in the South and in lower-income communities," the report concluded. "However, further study is needed regarding debt related to COVID-19.

Instant Insights /

Residents of South, low-income ZIP codes carry greatest medical debt

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