Medical debt soars to $140 billion and is examined as a social determinant by JAMA 

Photo: Kittiphan Teerawattanakul/Eye Em/Getty Photos

Unpaid healthcare bills are one of the largest sources of debt for Americans, reaching $140 billion last year, nearly double the amount previously thought.

This was the conclusion of a study published Tuesday in JAMA, in which researchers examined 10% percent of all credit reports from credit rating agency TransUnion for the years 2009 to 2020.

An editorial published July 20 in JAMA examines medical debt as a social determinant of health.

In June 2020, an estimated 17.8% of individuals had medical debt, with 13% accruing debt during the prior year. The mean amount was $429, with $311 accrued during the prior year.

The study revealed high levels of debt largely align with states that did not participate in the Affordable Care Act's Medicaid expansion program. 

The study indicated the amount of medical debt was highest among individuals living in the South and in lower-income communities, although the researchers noted further study would be needed regarding debt related to COVID-19.

The study did not take into account the growing volume of lawsuits hospitals have filed to collect delinquent payments or provide a complete picture of all medical bills owed to providers, suggesting the true volume of debt could be substantially larger.

WHY THIS MATTERS

On average, uncompensated care equates to approximately 8% of a hospital's expenses, according to Definitive Healthcare.

"Debt collections agencies place very low odds on recovering these debts," Benedic Ippolito, a senior fellow at the American Enterprise Institute, told The New York Times. "If you had to choose between keeping the lights on and paying your mortgage and paying some doctor you're never going to see again, I think a lot of us would make the same decision."

The JAMA study found that between 2013 and 2020, states that expanded Medicaid in 2014 experienced a decline in the mean flow of medical debt that was 34.0 percentage points greater than the states that did not expand Medicaid.

Last week, U.S. Senator Raphael Warnock (D-GA) joined Georgia healthcare advocates calling for the creation of a federal program to extend Medicaid coverage to millions of people stuck in the coverage gap in states that have refused expansion.

"Expanding Medicaid is the single most effective solution to closing our state's coverage gap," Senator Warnock said in a call with reporters.

THE LARGER TREND

Previous studies found that Medicaid expansion helped to reduce the percent of Americans with high levels of unpaid medical debt.

Thirty-nine states have expanded Medicaid under the Affordable Care Act.

Twitter: @dropdeaded209 
Email the writer: nathaneddy@gmail.com