Medical debt in the United States, in plain numbers.
More than 1 in 4 US adults said they or a family member owed medical or dental bills they could not pay in full (Urban Institute survey, December 2025). Insured people carry it too. Here is how it happens, who carries it and what helps.
Last updated .
Key facts
Adults who said they or a family member owed medical or dental bills they could not pay in full
- What it says
- 26.6%
- Applies to
- US adults, survey of December 2025
- Source
- Urban Institute
- As of
Adults with health insurance who reported medical debt
- What it says
- 25.7%
- Applies to
- Insured US adults, survey of December 2025
- Source
- Urban Institute
- As of
Adults with private insurance who were paying off medical bills over time
- What it says
- 32%Privately insured adults aged 19 to 64.
- Applies to
- Privately insured US adults aged 19 to 64, survey of 2025
- As of
Medical debt owed by US adults, at least
- What it says
- $220 billionData from December 2021 (Census survey), debts over $250.
- Applies to
- US adults who owed more than $250, December 2021
- As of
| Fact | What it says | Applies to | Source | As of |
|---|---|---|---|---|
| Adults who said they or a family member owed medical or dental bills they could not pay in full | 26.6% | US adults, survey of December 2025 | ||
| Adults with health insurance who reported medical debt | 25.7% | Insured US adults, survey of December 2025 | ||
| Adults with private insurance who were paying off medical bills over time | 32%Privately insured adults aged 19 to 64. | Privately insured US adults aged 19 to 64, survey of 2025 | ||
| Medical debt owed by US adults, at least | $220 billionData from December 2021 (Census survey), debts over $250. | US adults who owed more than $250, December 2021 |
The numbers
These are survey figures about adults in the United States, each with its source and year. None of them comes from our own work.
- How much people owe. Among adults with medical debt, the share who owed a thousand dollars or more was 53.8% (Urban Institute, December 2025).
- Large balances. Among the same adults, the share who owed five thousand dollars or more was 15.5% (Urban Institute, December 2025).
- Savings. Among adults with private insurance who were paying off medical bills over time, the share who used up all or part of their savings was 37% (Commonwealth Fund, 2025 Affordability Survey (Collins et al.), 2025) Privately insured adults aged 19 to 64.
- Food, heat and rent. Among the same adults, the share who cut back on basics like food, heat or rent was 30% (Commonwealth Fund, 2025 Affordability Survey (Collins et al.), 2025) Privately insured adults aged 19 to 64.
Surveys count medical debt in different ways, so their figures differ. Our page of medical debt statistics explains why.
How a bill becomes debt
A medical bill usually turns into medical debt in four stages. At each one, the person who owes it can still act.
- The bill. After care, the provider bills the patient's insurer, if there is one, and then sends the patient a statement for what is left. Our guide on how to read a medical bill explains each line.
- Past due. When a bill is not paid, reminders follow. This is still the best time to ask for financial assistance, an itemized bill or a payment plan. Our guide on asking a hospital for financial assistance walks through it.
- Collections. The provider may hand the account to a collection agency or sell it to a debt buyer. Among adults with medical debt, the share who had been contacted by a collection agency was 35.2% (Urban Institute, December 2025). Our guide on what happens if you don't pay a medical bill covers the rules collectors follow.
- Credit reports. Some unpaid medical collections can reach a credit report. The three national credit bureaus leave off paid medical collections and wait a year before an unpaid one can appear Source 4. They also leave off collections that started with a balance under $500 (Equifax, Experian and TransUnion joint release, Effective April 11, 2023). This is their own policy, not a law, and larger unpaid medical collections can still be reported in states without a ban of their own Source 5. Our guide on medical debt and your credit report has the details.
Why it happens
Hospital bills are the most common source. Among adults with medical debt, the share who owed money for hospital care was 52.1% (Urban Institute, December 2025). Many also owed specialists, dentists or their regular doctors, and many owed more than one of them Source 1.
Having insurance does not prevent it. Health plans leave deductibles, copays and coinsurance to the patient, and some care is not covered at all. Among adults with private insurance who were paying off medical bills over time, the share who said the debt came from hospital care was 64% (Commonwealth Fund, 2025 Affordability Survey (Collins et al.), 2025) Privately insured adults aged 19 to 64.
Many people also get bills they did not expect. Among insured adults aged 19 to 64, the share who got a bill or a copay in the past year for care they thought should have been free or covered was 45% (Commonwealth Fund, Gupta et al., April 18 to July 31, 2023).
Who carries it
Medical debt reaches people at every income level, with insurance and without. Some groups reported it more often than others in the newest national survey. Each row below gives one group's share.
Adults in families with incomes between one and two times the federal poverty level, the highest share of any income group
- What it says
- 37.8%Shares by group from one survey; they describe who reported debt, not why.
- Applies to
- US adults by family income, survey of December 2025
- Source
- Urban Institute
- As of
Black adults
- What it says
- 37.5%Shares by group from one survey; they describe who reported debt, not why.
- Applies to
- US adults by race and ethnicity, survey of December 2025
- Source
- Urban Institute
- As of
Hispanic adults
- What it says
- 34.8%Shares by group from one survey; they describe who reported debt, not why.
- Applies to
- US adults by race and ethnicity, survey of December 2025
- Source
- Urban Institute
- As of
Adults with disabilities
- What it says
- 41.1%Shares by group from one survey; they describe who reported debt, not why.
- Applies to
- US adults by disability, survey of December 2025
- Source
- Urban Institute
- As of
Adults without health insurance
- What it says
- 35.2%
- Applies to
- Uninsured US adults, survey of December 2025
- Source
- Urban Institute
- As of
| Fact | What it says | Applies to | Source | As of |
|---|---|---|---|---|
| Adults in families with incomes between one and two times the federal poverty level, the highest share of any income group | 37.8%Shares by group from one survey; they describe who reported debt, not why. | US adults by family income, survey of December 2025 | ||
| Black adults | 37.5%Shares by group from one survey; they describe who reported debt, not why. | US adults by race and ethnicity, survey of December 2025 | ||
| Hispanic adults | 34.8%Shares by group from one survey; they describe who reported debt, not why. | US adults by race and ethnicity, survey of December 2025 | ||
| Adults with disabilities | 41.1%Shares by group from one survey; they describe who reported debt, not why. | US adults by disability, survey of December 2025 | ||
| Adults without health insurance | 35.2% | Uninsured US adults, survey of December 2025 |
All the numbers, by state and by group, are on our statistics page, with how each one was measured.
What helps today
We can't cancel a specific person's bill on request. If you have a medical bill now, these can help:
- Ask the hospital for financial assistance. Every nonprofit hospital must have a written financial assistance policy that covers emergency and other medically necessary care Source 7Source 8.
- Check whether financial assistance could cover a bill. It takes a few questions, and nothing you enter is stored.
- Ask for an itemized bill and check every charge before you pay.
- Use our letters and scripts to ask for help in writing.
- Check a letter that uses our name. We have not mailed any relief letters yet.
What we do about it
We plan to raise money, buy medical debt in bulk and cancel it. Cancelling ends the obligation to pay that debt and stops collection on it. We have not bought any medical debt yet.
- Our work lists each line of our work and where it stands today.
- How it works explains how medical debt is bought and cancelled.
- What cancelling medical debt does, and what it doesn't sums up the only randomized study so far, which found no average improvement in health or financial well-being Source 9.
- Our impact page starts at zero. Every debt we cancel will be posted there.
Next step
If you need help with your own situation, these can help:
Sources
Note 1 Urban Institute, "More than One-Quarter of US Adults Had Medical Debt in 2025" (M. Karpman). Published October 2026. Last checked November 2, 2026.
Note 2 Commonwealth Fund, 2025 Affordability Survey (Collins et al.). Published September 2026. Privately insured adults aged 19 to 64. Last checked November 2, 2026.
Note 3 Peterson-KFF Health System Tracker, "The burden of medical debt in the United States". Published February 12, 2024. Data from December 2021 (Census survey), debts over $250. Last checked November 2, 2026.
Note 4 Equifax, Experian and TransUnion joint release. Published March 18, 2022. Last checked November 2, 2026.
Note 5 National Consumer Law Center, "The Latest on Keeping Medical Debt Out of Credit Reports". Published September 21, 2026. Last checked November 2, 2026.
Note 6 Commonwealth Fund, Gupta et al., "Unforeseen Health Care Bills and Coverage Denials by Health Insurers in the U.S.". Published August 1, 2024. Last checked November 2, 2026.
Note 7 IRS, "Requirements for 501(c)(3) Hospitals Under the Affordable Care Act - Section 501(r)". Published July 2, 2026. Last checked November 2, 2026.
Note 8 IRS, "Financial Assistance Policy and Emergency Medical Care Policy - Section 501(r)(4)". Published July 3, 2026. Last checked November 2, 2026.
Note 9 Kluender, Mahoney, Wong and Yin, "The Effects of Medical Debt Relief: Evidence from Two Randomized Experiments", NBER WP 32315; Quarterly Journal of Economics 140(2):1187-1241 (2025). Published November 2024. Relief ends the obligation to pay that debt and stops collection on it. Last checked November 2, 2026.
No changes since this page was first published.
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