Problems Paying Medical Bills Increase for U.S. Families Between 2003 and 2007

1 in 5 Americans Faced Medical Bill Problems in 2007, up from 1 in 7 in 2003

News Release
Sept. 24, 2008

Alwyn Cassil (202) 264-3484 or

WASHINGTON, DC—The proportion of Americans in families with problems paying medical bills increased to 19.4 percent in 2007, up from 15.1 percent in 2003, according to a national study released today by the Center for Studying Health System Change (HSC) and funded by The Commonwealth Fund.

The growth translates to more than 57 million Americans in families with medical bill problems in 2007—an increase of 14 million people since 2003, according to findings from HSC’s 2007 Health Tracking Household Survey, a nationally representative survey with information on 18,000 people; the survey had a 43 percent response rate.

While rates of medical bill problems remained stable for elderly Americans, more nonelderly insured and uninsured people, alike, faced medical bill problems in 2007, the study found. And, although the rate of medical bill problems is much higher for uninsured people, most people with medical bill problems—42.5 million—hyad insurance coverage,

"Increases in problems paying medical bills are affecting not only those who have always struggled with medical costs—low-income and uninsured people—but also an increasing number of insured middle-income families," said study author Peter J. Cunningham, Ph.D., an HSC senior fellow.

About 2.2 million people with medical bill problems were in families that filed for bankruptcy as a result of their medical bills, and a much larger number reported other financial consequences, such as problems paying for food and housing. Likewise, people with medical bill problems—both insured and uninsured— reported much higher levels of unmet medical needs in the previous year because of costs compared with people without medical bill problems.

"The increase in medical bill problems—especially among insured people—is the main reason why more people reported unmet medical needs because of cost in 2007 than in 2003," Cunningham said.

The study’s findings are detailed in a new HSC Tracking Report—Trade-Offs Getting Tougher: Problems Paying Medical Bills Increase for U.S. Families, 2003-2007available here.

Other key findings include:

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The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nation’s changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded principally by the Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.