Medical debt and collections in the United States.
Level 4 - case-series / case-control
Cross-sectional survey study linked to administrative credit bureau records (graded by design analogy).
PubMed 40896378 · doi:10.1093/haschl/qxaf159
What was done
Researchers analyzed data from two nationally representative US surveys conducted in 2024 linked to respondents' credit bureau records. They measured self-reported medical debt, payment plans, past-due bills, and third-party collection contacts, and compared these directly with medical collections reported on credit records.
What was found
In 2024, 36% of US households had medical debt, 21% had a past-due medical bill, and 23% were paying a medical bill over time to a provider. Additionally, 15% of individuals were contacted by third-party debt collectors, while only 12% had any medical collection on their credit record and 5% had a new collection. Active collections only partially overlapped with credit bureau data. For individuals with active medical collections, mean total debt was bounded between $2456 and $7931.
Why it matters
Credit reports omit provider-held debts and fail to capture all active third-party collections, meaning researchers and policymakers relying exclusively on credit bureaus will substantially underestimate the scope of US medical debt.
Limits
The abstract does not report the total participant sample size across the two surveys. Findings rely on cross-sectional survey data subject to self-report and recall biases. Longitudinal outcomes and debt resolution paths were not assessed.
Cited by
- supports 30% of US households carry medical or dental debt.