The affordability crisis affecting Americans extends well beyond gas, groceries and utilities. Healthcare costs are a top concern among voters in this year’s midterm elections. Besides experiencing increases in premiums, deductibles and patient cost-sharing, tens of millions of Americans have medical debt. Multiple recent analyses shows how widespread medical debt is, even for people who have health insurance.

Medical debt is defined as experiencing problems paying or being unable to afford any medical bills in the past 12 months, including those for doctors, dentists, hospitals, therapists, medication, equipment, nursing home or home care.

The ubiquity and level of medical debt in the United States is a uniquely American phenomenon , when compared to the country’s peers. It’s driven by a combination of factors such as relatively high percentages of people who have no health insurance or high deductibles and co-payments for those who do have health coverage.

And 7.4% of U.S. residents experience catastrophic healthcare expenses annually, more than double the rate of any other developed nation. Here, the term catastrophic is defined as out-of-pocket spending that exceeds 40% of a household’s income after basic necessities have been met.

Furthermore, estimates suggest that inability to afford healthcare costs contributes to at least 530,000 personal bankruptcy filings in the U.S. annually. Approximately two-thirds of such bankruptcies are associated with medical expenses or illness-related loss of work.

Financial burdens related to healthcare occur across income levels and are most common among people who don’t have health insurance. But, according to a new Urban Institute analysis supported by the Robert Wood Johnson Foundation, 27% of U.S. adults said that they or their family members owed medical debt in 2025, including 26% of adults with health insurance. Hospitals were the largest source of debt, followed by specialist care, dental providers and primary care physicians.

Approximately 54% of adults who reported having medical debt said their families owed at least $1,000, with 16% saying it was $5,000 or more. Overall, 15% of U.S. adults revealed they have family medical bills that were past due or that they were unable to pay.

Surveys have consistently shown disparities across socioeconomic and ethnic groups. Low-income adults and those with a disability or in fair or poor health were more likely to have medical debt. The issue disproportionately impacts Southern, Black and Hispanic populations. To illustrate, more than a third of Black and Hispanic adults reported holding medical debt.

Even the elderly and disabled enrolled in Medicare haven’t been spared the burdens of medical debt. Observed trends indicate a rising number of Medicare beneficiaries who are burdened financially with this problem, with nearly one in five saying that they or a family member were affected.

And an American Cancer Society survey published last year of cancer patients and survivors found that more than half reported medical debt resulting from cancer treatment despite nearly all of the respondents having health insurance. Oncologists coined the term financial toxicity to describe what cancer patients must endure besides the side effects of treatment.

In the commercial sector, employers are responding to the increasing price of health insurance by shifting costs to employees in the form of higher premiums, deductibles and patient cost-sharing, including dropping coverage of certain items like the popular GLP-1s for weight loss. In turn, this will likely exacerbate the already existing debt problem.

Also, the burden of medical debt could worsen as restrictions on access to Medicaid and Affordable Care Act exchanges take effect. Millions of people are Medicaid and ACA marketplace coverage due to federal legislation and accompanying policy changes.