About 20 million American adults owe medical debt, roughly 1 in 12 people. That number comes from Census survey data counting people who owe more than $250 in unpaid medical bills. But the true scope depends on how you define “medical debt.” The Federal Reserve’s annual household survey puts the figure at 17% of all adults, a rate that has hovered between 15% and 18% every year since 2019. And when you include health care charges put on credit cards or money borrowed from family, KFF polling found that 41% of adults carry some form of health care debt.
How Much Debt Are We Talking About?
Collectively, Americans hold more than $49 billion in medical bills that have gone to collections, according to the Consumer Financial Protection Bureau. At the individual level, about 14 million people (6% of adults) owe more than $1,000, and roughly 3 million people owe more than $10,000.
The financial weight of that debt varies enormously depending on income. About 19% of households below the poverty line carry medical debt, which is essentially the same rate as households above the poverty line. The difference is what that debt does to them. Among households in poverty, 11.3% face what researchers call a high medical debt burden, meaning the debt exceeds 20% of their annual income. For households above the poverty line, that figure drops to 3%. Households with zero or negative net worth are hit hardest: 14% carry a high debt burden, compared to less than 1% of households worth $500,000 or more.
Who Carries the Most Medical Debt
Medical debt does not fall evenly across the population. Black households are far more likely to carry it: 27.9% reported medical debt compared to 17.2% of white non-Hispanic households and 9.7% of Asian households. Hispanic households also face higher rates (21.7%) than non-Hispanic households (18.6%).
Age plays a clear role. For every age group under 65, at least 20% of households hold medical debt. Once people reach Medicare eligibility at 65, the rate drops sharply: 15% for ages 65 to 69, 11% for 70 to 74, and just 9% for those 75 and older. That pattern strongly suggests that gaps in insurance coverage for working-age adults are a major driver.
Families with young children are especially vulnerable. Nearly 25% of households with children under 18 carry medical debt, and the rate ticks even higher (25.4%) for households with a child under 5. Households without children report medical debt at just 16.5%.
Health Problems and Hospital Stays
The single strongest predictor of medical debt is health status itself. About 31% of households with a member in fair or poor health carry medical debt, more than double the 14.4% rate for households where everyone is in good health. A hospital stay has a similar effect: 31.3% of households where someone was hospitalized hold medical debt, compared to 15.8% of those without a hospitalization. Households with a disabled member also face elevated rates at 26.5%.
These numbers point to a straightforward problem. The people who need the most care are the ones most likely to end up owing money they can’t easily pay. Chronic illness, disability, and serious acute events like surgery or an ER visit all generate the kind of large, complex bills that outpace what insurance covers or what families have saved.
Education and Medical Debt
Education level tracks closely with medical debt, though not in a perfectly linear way. Households where the highest degree earned was “some college but no degree” had the highest rate at 26.2%. That group likely includes people who took on college costs without gaining the earning boost of a completed degree. Households with a bachelor’s degree reported lower rates (15.5%), and those with a graduate or professional degree were the least likely to carry medical debt (10.9%).
Where You Live Matters
Medical debt is heavily concentrated in states that chose not to expand Medicaid under the Affordable Care Act. Five of the ten states with the highest share of residents owing medical bills, including Texas, North Carolina, South Carolina, Oklahoma, and Tennessee, declined the expansion. About one in four residents in those states have medical debt in collections.
Minnesota offers the starkest contrast. With one of the most generous Medicaid programs in the country, just 3% of its residents have medical debt in collections, the lowest rate of any state. Research has found that Medicaid expansion reduced the number of unpaid bills going to collection agencies and cut the amount individuals had in collections by about $1,000.
Medical Debt and Your Credit Report
The three major credit bureaus voluntarily removed medical debts under $500 from credit reports in recent years, a change that cleared millions of accounts. The CFPB attempted to go further with a rule that would have banned all medical debt from credit reports, but a federal court in Texas vacated that rule in July 2025, finding it exceeded the agency’s authority under the Fair Credit Reporting Act. For now, medical debts above $500 that go to collections can still appear on your credit report and affect your score.
That matters because medical debt in collections can lower your credit score for years, making it harder to rent an apartment, buy a car, or qualify for a mortgage. Unlike other consumer debt, medical debt is rarely the result of discretionary spending. It typically comes from events people didn’t choose and couldn’t have predicted.