Medical Debt, by race

The share of working-age Americans with medical debt fell from 24% in 2019 to 17% in 2021. However, in 2021, 23% of Black adults still had medical debt compared to 16% of white adults.

Share of working-age adults (18-64) who reported medical debt, by race/ethnicity

March 2018 - April 2021

Source: Urban Institute Health Reform Monitoring Survey. Notes: Medical debt is self-reported, and does not indicate whether the debt is past due. “Other race” includes persons who reported a race not listed, or people who reported more than one race. *Statistically significant decline from March 2019.

Adults with medical debt often delay getting needed medical attention.1 During the pandemic, the Families First Coronavirus Response Act boosted enrollments in public health insurance plans such as Medicaid, which contributed to lowering the share of adults with medical debt from 24% in March 2019 to 17% in April 2021.¹ But far more Black and Latino working-age adults continued to have medical debt in April 2021 (23% and 20% respectively) compared to white working-age adults (16%).

When the health emergency officially ends, many people will lose their public health insurance.² Residents of states that have not expanded Medicaid are particularly at risk. A June 2022 survey of Georgia adults, where Medicaid has not been expanded, found that 37% of Black Georgians, 33% of Hispanic Georgians, and 25% of white Georgians now have medical debt.³

The 7 Southern states that have not expanded Medicaid (AL, GA, FL, MS, NC, SC, and TN) can reduce medical debt levels by adopting Medicaid expansion. States that expanded Medicaid by 2014 saw a greater decline in medical debt among their residents than did states that failed to expand Medicaid.⁴

1. “Medical Debt Fell during the Pandemic. How Can the Decline Be Sustained?” Karpman, Martinchek, and Braga. The Urban Institute. May, 2022. https://www.urban.org/sites/default/files/2022-05/Medical%20Debt%20Fell%20during%20the%20Pandemic%20How%20Can%20the%20Decline%20Be%20Sustained.pdf

2. “Time to Get It Right: State Actions Now Can Preserve Medicaid Coverage When Public Health Emergency Ends”. Wagner, Erzouki. Center on Budget and Policy Priorities. May, 2022. https://www.cbpp.org/research/health/time-to-get-it-right-state-actions-now-can-preserve-medicaid-coverage-when-public 

3. “A Survey of Georgia Residents: State of the State”. The Southern Economic Advancement Project. June, 2022. https://theseap.org/wp-content/uploads/2022/07/PerryUndem_GA_6.29-Deck.pdf 

4. “Medical Debt in the US, 2009-2020”. Kluender, Mahoney, Wong, et al. JAMA Network. July, 2021. https://jamanetwork.com/journals/jama/fullarticle/2782187