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Medical debt impacts 1 in 3 insured adults

Health insurance coverage doesn't protect everyone from incurring medical debt, with most debt totaling $2,000 or more.

Sara Heath
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Published: 18 Sep 2026

A third of adults with private insurance are managing medical debt, with a new survey from the Commonwealth Fund underscoring the impact rising healthcare costs are having on patients.

The survey of 6,535 privately insured adults under age 65 showed that having health insurance coverage isn't enough to insulate people from high healthcare costs anymore.

"Medical debt is often viewed as a problem limited to people who are uninsured or who face a major medical emergency," Sara R. Collins, a study coauthor and Commonwealth Fund senior scholar for Expanding Coverage and Access and Tracking Health System Performance, said in a press release. "But this survey shows that it is also widespread among Americans with private insurance."

The total number of adults carrying some amount of medical debt hovers at 32%. However, that rate is higher for people with low or moderate incomes (38%), Black people (41%), Hispanic people (38%) and people living in the South (39%).

To add insult to injury, the amount of medical debt people carry is not small.

According to the survey, 46% of people with medical debt have debt reaching as high as $2,000 or more. About a fifth owe less than $500, and 36% owe between $500 and $1,999.

These figures are striking, considering how few people are prepared to pay an expensive medical bill. The data showed that more than a third of Americans said they wouldn't be able to pay an unexpected $1,000 medical bill, while half said they could.

Problems paying off a $1,000 medical bill were most common among low-income people (55%), women (43%), Black people (54%), Hispanic people (52%) and folks living in the South (41%)

Most of the debt (64%) comes from hospital services, delivered either on an inpatient or outpatient basis or within the emergency department. It's to be expected that these types of high-cost services might result in medical debt, but according to Collins, it's surprising that low-acuity care yields medical debt as often as it does.

"Moreover, [medical debt] often stems from more routine care, including doctors’ office visits and treatment for chronic conditions," she said.

According to the survey, 43% of those with medical debt have debt from doctor's office visits, while another 38% said their debt stemmed from lab work or diagnostic tests. About four in 10 (39%) said their medical debt was related to an ongoing chronic condition.

Managing, paying off medical debt raises stress levels

Medical debt is causing stress on consumers' lives, the report indicated, with 68% of respondents saying their unpaid medical bills cause them worry or anxiety. Just under a third said they've delayed or avoided necessary healthcare to try and manage their medical debt, while the same proportion said they've cut back on basic necessities, such as food, heat or rent.

Even with these measures, medical debt is stretching people thin. More than a third of respondents managing medical debt said they've used part or all of their savings to pay off their debt. And while 78% are currently making payments directly to their healthcare provider, for others, things have become more dire.

 A quarter of respondents said they're making payments to a debt collection agency, while a similar share said their debt had been reported to a credit agency.

Healthcare industry solutions to medical debt

According to Collins, these figures indicate a serious failure of the healthcare industry.

"When insured people are left owing thousands of dollars for their care, coverage is falling short of its most basic purpose: protecting people financially when they get sick," she asserted.

Patients tend to agree: 64% of respondents blame health insurance companies specifically for their medical debt. Another 57% blamed the broader healthcare system.

"No patient should have to avoid or delay care or experience anxiety about medical bills and debt," Joseph R. Betancourt, M.D., Commonwealth Fund president, said in a statement. "We can and should do better. There are clear steps policymakers, insurers, and hospitals can take to ensure people can get and afford the care they need, when they need it most."

Respondents were enthusiastic about the procedural changes the Commonwealth Fund asked them about. For example, 93% said it would be at least somewhat helpful (66% said it would be very helpful) to have access to interest-free payment plans.

Another 94% said it'd be at least somewhat helpful to have financial assistance from hospitals, while 90% said the same about having medical debt removed from consumer credit reports.

Sara Heath is an executive editor at Xtelligent Healthcare Media, where she covers patient engagement, healthcare policy and health IT.

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