Percentage of Americans with past-due medical bills remained unchanged 2015-2021

(Washington, D.C.) – A new Issue Brief published today by the Employee Benefit Research Institute (EBRI) entitled, “Bitter Pill: A Demographic Analysis of Unpaid Medical Bills,” found that, despite increases in cost sharing, the percentage of working-age adults with past-due medical debt has remained the same since 2015.  However, those with past-due medical bills still do face cascading effects on their health and personal finances.

The study explored the relationship between past-due medical bills and demographics. The study focuses on working-age adults, because they have experienced an increase in cost sharing in their health benefits.  Data from the FINRA Foundation’s 2021 National Financial Capability Study was used for the research analysis.

Key findings in the study include:

• Despite the increase in cost sharing, the percentage of Americans who report having past-due bills from a health care or medical service provider has not changed from 2015 to 2021.
• While the percentage of Americans who report past-due medical bills has remained in the low 20 percent range since 2015, it has gone down from 26 percent in 2012.
• Compared to other sources of debt, Americans are less likely to have past-due medical bills.
• Women are slightly more likely than men to report that they have past-due medical bills.
• Black adults are more likely than those in other race/ethnicity groups to report that they have past-due medical bills.
• Health insurance and living in a Medicaid expansion state reduce the percentage of individuals reporting that they have past-due medical bills.

“Despite deductibles trending upward alongside coinsurance rates and copays for nearly two decades, we found the share of adults with past-due medical bills has remained stable over the past six years and has decreased slightly over the past decade,” said Paul Fronstin, director, Health Benefits Research, EBRI.  “The data presented in this paper are timely given the recent announcement that the three major credit bureaus are overhauling how medical debt is reflected on credit reports.”

The National Financial Capability Study has been conducted every three years since 2009 by the FINRA Investor Education Foundation to benchmark key indicators of financial capability and to evaluate how these indicators vary with demographic, behavioral, attitudinal and financial literacy characteristics.  More than 27,100 American adults ages 18 and older were surveyed for the 2021 study.  The study was conducted from June 2021 to October 2021.

The complete Issue Brief, “Bitter Pill: A Demographic Analysis of Unpaid Medical Bills,” can be viewed by visiting https://www.ebri.org/docs/default-source/ebri-issue-brief/ebri_ib_568_bitterpill-1sept22.pdf .

This Issue Brief was supported by a grant from the FINRA Investor Education Foundation and was conducted by the EBRI Center for Research on Health Benefits Innovation, which receives funding from Aon, Blue Cross Blue Shield Association, FINRA Investor Education Foundation, ICUBA, JP Morgan Chase, Pfizer and PhRMA.

The Employee Benefit Research Institute is a non-profit, independent and unbiased research organization that provides the most authoritative and objective information about critical issues relating to employee benefit programs in the United States. For more information, visit www.ebri.org.