This is the billion-dollar amount that Americans borrowed to pay for healthcare: who owes the most?

Medical debt in the United States has soared to $220 billion, with new reports showing that in 2024 alone, 31 million Americans borrowed $74 billion to cover healthcare expenses. These figures, published by the West Health-Gallup Healthcare Affordability Index, highlight that for these individuals—who represent roughly 12% of the population—taking on medical debt was necessary “despite most having some form of health insurance.”

Not all of these people failed to pay back their debt, but in 2023, the Urban Institute reported that around 15% of adults under 65 had, or knew someone with, “unpaid medical bills that were past due.” Further, this figure does not include individuals who paid off their medical debt with a credit card and now carry a balance on that line of credit.

The growing dependence on third-party debt-collection companies

In October 2024, the Consumer Financial Protection Bureau (CFPB) estimated that 100 million Americans hold a total of $220 billion in medical debt.

At the time, the CFPB warned of illegal practices by debt collectors and insurance companies that hire third-party firms to recover debts. The agency found that these companies often had engaged ‘double-dipping’ consumers by “charging for services already covered by insurance.” The CFPB also noted an increase in reports from consumers who had spoken with a representative who misrepresented their right to contest the bill.

“The CFPB has received complaints from people receiving collections notices for debts they do not owe—debts that were already paid by the consumer or their insurance, or that should have been covered by insurance, government programs, or hospital financial assistance.”

A major part of the problem is that hospitals and insurance companies are increasingly outsourcing “medical billing and collection activities” to third-party companies, making the process even more complex and opaque.

Where the burden of medical debt falls

The 2024 West Health-Gallup data is critical, as up-to-date statistics on medical debt remain scarce.

Among survey respondents with incomes under $48,000, more than two-thirds reported feeling “very” or “somewhat” concerned that a major health event in their household could lead to medical debt. For those with higher incomes, this rate was around one-third. However, the data does not dive much deeper into how income and poverty relate to medical debt.

A Kaiser Family Foundation (KFF) report last year found that individuals with medical debt are far more likely to experience financial distress than those without.

This shouldn’t surprise anyone. If you have quality insurance that caps out-of-pocket expenses and covers the vast majority of healthcare needs, medical debt shouldn’t be a major problem. However, KFF found that individuals with medical debt are more likely to have suffered an overdraw in their checking account and take a cash advance.

What about age?

Though adults under 50 are more likely to take on medical debt, the data from West Health-Gallup shows that as borrowers age their debt tends to be higher.

For instance, more than half of all respondents, 58 percent, borrowed more than $500. However, the average debt borrowed by those ages 30 to 49 was around $750, while those 50 and older had taken on more than $3,000.

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