Health insurance isn't stopping medical debt: 1 in 4 adults owe

Medical debt is no longer only a problem for the uninsured. More than one in four U.S. adults (27%) said they or a family member owed medical debt in 2025, including 26% of adults with health insurance, according to a new Urban Institute analysis supported by the Robert Wood Johnson Foundation.

The findings add to evidence that coverage alone doesn't protect patients from the cost of care as medical debt has spread beyond the uninsured. Among adults with medical debt, more than half owed at least $1,000, and more than a third had been contacted by a collection agency in the past year.

The burden falls unevenly. Adults with low incomes, those with a disability or in fair or poor health, and those ages 45 to 54 were more likely to carry medical debt, as were Black and Hispanic adults. Even older adults with Medicare coverage weren't immune.

The data also point directly at the care delivery system. Hospitals were the most commonly reported source of debt, followed by specialists, dental care providers and general doctors, which puts physician practices among the creditors patients are struggling to pay.

Researchers warn the problem could worsen as employers shift rising insurance costs to workers and federal policy changes reduce Medicaid and Marketplace coverage. That outlook adds weight to policy proposals to cap hospital prices and curb medical debt.