The data: Thirty-two percent of working-age adults with private health insurance are currently paying off healthcare bills or carrying medical debt, according to a recently published Commonwealth Fund report based on an October 2025 survey of 4,121 US adults ages 19 to 64.

Among those with medical debt:

• 81% owe at least $500 and 46% owe at least $2,000.
• Hospital care is the leading source of medical debt, cited by 64% of those with outstanding balances.

Why it matters: Medical debt is often associated with the uninsured, but insured patients also carry significant balances. Rising claim denials and high-deductible plans are likely increasing insured patients’ share of healthcare costs.

Medical debt is harming respondents’ health and ability to afford other essentials. Among patients who are paying off bills or debt:

• 37% have used all or part of their savings to pay off medical bills.
• 30% put off or skipped needed care or treatment.
• 30% cut back on necessities such as food, heat, or rent.
• 22% have had a household member receiving a lower credit rating.

Recent public- and private-sector efforts aim to protect people with medical debt, though federal policy has shifted. Since 2014, nonprofit Undue Medical Debt says it has used donations and government funds to erase about $50 billion in debt for 31.6 million Americans. Government support is a bit more complicated: The Trump administration effectively reversed a Biden-era rule that would have barred medical debt from most credit reports used by lenders. Meanwhile, some states have enacted laws to protect consumers, including prohibiting or restricting the inclusion of medical debt in credit reports and disallowing lawsuits over medical bills that are $500 or less.

Implications for the healthcare system: About 15 million people have an estimated $49 billion in medical debt on their credit reports, meaning many Americans will continue to face financial consequences, from personal borrowing power to difficulty qualifying for a mortgage or rent. Medical debt will also keep plenty of people from seeking care out of fear of accumulating more unpaid bills and facing unaffordable out-of-pocket costs.

Addressing the problem requires generous insurance coverage that does not shift the cost burden onto patients. Nearer-term, workable solutions include: hospitals and clinics expanding free or discounted care, credit bureaus extending credit-reporting grace periods, and provider billing departments offering interest-free payment plans negotiated with financial counselors. However, it’s worth noting that these measures can reduce revenue or weaken collection leverage, giving organizations little incentive to adopt them broadly.

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