Medical Debt Statistics (2026)

People in the United States owe at least $220 billion in medical debt, according to KFF's analysis of the Census Bureau's 2021 Survey of Income and Program Participation.

The phrase at least is doing real work. The survey asks whether an adult owes money for medical bills and how much, which captures debt people recognise as medical and misses debt that has been moved onto a credit card or into a personal loan.

That means the figure is a floor rather than an estimate of the full burden, and the true number including debt that has changed form is necessarily larger.

About 14 million adults, 6% of the adult population, owe more than $1,000.

About 3 million, roughly 1% of adults, owe more than $10,000.

So the burden is concentrated: a small group carries balances large enough to be financially defining, while the majority of medical debt sits below the $1,000 threshold.

17.7% of adults in South Dakota carry medical debt. In Hawaii the figure is 2.3% and in the District of Columbia 2.7%.

The other states at the top are Mississippi at 15.2%, North Carolina at 13.4%, West Virginia at 13.3% and Georgia at 12.7%.

A near-eightfold gap between the highest and lowest states is larger than almost any other consumer finance measure varies geographically, and it reflects differences in insurance coverage and state policy rather than in how much care people need.

The CFPB found that medical debt is the most common collection tradeline reported on consumer credit records.

People also report being contacted by debt collectors about medical debt more than any other type of debt.

That combination is what makes medical debt different from other consumer borrowing. Most debt is entered into deliberately. This is generated by an event, frequently without a price being quoted first.

It is rarely a decision. A person does not compare terms before an emergency admission, and in many cases the price is not knowable in advance.

It is frequently disputed rather than simply unpaid: billing errors, coverage disagreements and coordination between multiple providers all generate balances that the patient believes they do not owe.

And it arrives alongside the event that caused it, which is often the same event that reduced the person's ability to earn.

The No Surprises Act took effect in January 2022. It protects people covered under group and individual health plans from surprise bills for most emergency services, for non-emergency services from out-of-network providers at in-network facilities, and for out-of-network air ambulance services.

It establishes an independent dispute resolution process for payment disputes between plans and providers, which moves the argument away from the patient.

It also gives uninsured and self-pay individuals a dispute route when a bill is substantially greater than the good faith estimate the provider supplied.

For uninsured and self-pay patients, providers must supply a good faith estimate of expected charges.

If the final bill comes in substantially above that estimate, there is a dispute resolution process available.

That is a genuine consumer protection and it depends entirely on the patient having asked for and kept the estimate, which is why it is worth requesting one in writing before any scheduled non-emergency care.

Ground ambulance services were left out of the surprise billing protections, which is the largest remaining gap and a common source of unexpected bills.

The Act addresses surprise out-of-network billing rather than the affordability of in-network care, so a large but expected bill is untouched by it.

And it does not retroactively affect debt incurred before it took effect.

Because medical debt is the most common collection tradeline, it has historically been a major driver of damaged credit files.

A collection entry affects access to credit, and in some cases to housing and employment, long after the underlying bill is resolved.

The practical implication is that a disputed medical bill is worth resolving formally rather than ignoring, because the consequence attaches to the credit file rather than to the dispute.

Request an itemised bill. Billing errors are common enough that the itemised version frequently changes the amount.

Ask the provider about financial assistance or charity care. Nonprofit hospitals operate assistance policies, and eligibility is often wider than patients assume.

Ask about a payment plan directly with the provider before putting the balance on a credit card, because moving medical debt onto a card converts it into ordinary consumer debt at ordinary consumer interest rates.

Medical debt is the clearest argument for an emergency fund that exists in the data, because it is the largest category of unplanned household expense that arrives without warning.

It is also a reason to understand your plan's out-of-pocket maximum before you need it, since that figure is the ceiling on what a covered year can cost.

For anyone on a high-deductible plan, an HSA is the account designed for exactly this, and it is the only account taxed nowhere when used for qualified medical costs.

The $220 billion figure and the state shares come from KFF's analysis of the 2021 Survey of Income and Program Participation, a nationally representative Census survey that asks every adult in a household about medical bills owed.

The data is from 2021, so it predates both the No Surprises Act taking effect and subsequent changes to how medical debt is reported on credit files.

The direction those changes push is toward a smaller measured burden, so treating the 2021 figures as a current level rather than a baseline would overstate the position today.

Debt totals, thresholds and state shares are from KFF's analysis of the Census Bureau's 2021 Survey of Income and Program Participation, published 12 February 2024.

The standing of medical debt on credit reports is from the CFPB's report Medical debt burden in the United States, published 1 March 2022.

The statutory protections are quoted from the CMS fact sheet on the No Surprises Act, published 3 January 2022.