79 million US adults have medical bill problems or are paying off medical debt

In a new Commonwealth Fund issue brief which accompanies the report, Seeing Red: The Growing Problem of Medical Debt and Bills, the authors explain that uninsured and underinsured adults are more at risk of having medical bill problems and medical debt than those with adequate insurance coverage. Three in five adults who are uninsured or underinsured face these challenges, more than double the rate of those who had adequate insurance all year (26 percent). Notably, adults 65 years and older were far less likely to report medical bill problems or debt than younger adults because they are covered by Medicare and may also have supplemental private coverage, and in the case of low-income individuals, may have Medicaid. Just 19 percent of adults over 65—half the rate for adults under 65 (41%)—reported any medical bill problems or debt.

"The current economic slowdown makes it even more urgent for a new Administration to make universal and affordable health insurance a high priority in 2009, to ensure that no American suffers financial hardship as a result of serious illness," said Commonwealth Fund President Karen Davis.

The report also finds that more working-age adults are delaying or avoiding needed medical care, such as skipping doses of medication or not filling prescriptions, because of health care costs. Forty-five percent of adults reported problems getting care because of costs in 2007, a dramatic increase from 29 percent in 2001. Increasing numbers of adults are spending high proportions of their income on health care. One-third of U.S. working-age adults spent 10 percent or more of their income on out-of-pocket medical expenses and health insurance premiums in 2007, up from 21 percent in 2001.

The proportion of Americans who are uninsured continues to grow. More than one-quarter (28%) of U.S. adults ages 19 to 64, or an estimated 50 million people, were uninsured for some time in 2007, compared with 24 percent in 2001. But even having insurance coverage does not guarantee protection from medical bill problems and debt. The proportion of those who are underinsured increased from 9 percent to 14 percent, or 25 million people, between 2003 and 2007. Sixty-one percent of those with medical bill problems or accumulated medical debt were insured at the time care was provided.

Other key survey findings include: