Medical debt has become a nationwide crisis, with 13% of U.S. adults impacted by past-due medical bills, according to data collected by the Urban Institute, a Washington, D.C., public policy
A year ago, Deborah Mais was a passenger in a morning car wreck in College Station, Texas, that left her with a traumatic brain injury and a growing pile of seemingly insurmountable medical bills.
West Virginia, South Carolina, Oklahoma, North Carolina and Texas have the highest level of medical debt in the country. Three of those states — North Carolina, South Carolina and Texas — are home to 57 of the top 100 counties with the highest levels of medical debt, according to the data. Another 20 of those counties are in Georgia.
The debt has more than financial consequences. Mais’ financial struggles have disrupted her ability to heal at every step of the way, her family says. Though she had a job cleaning apartments at the time of the accident, she didn’t have health or car insurance. “I’m scared to even look,” Francis said. “People aren't prepared for the aftermath of a situation like this, the toll it takes on everyone.”
Comeau has about $5,000 in debt collections, despite qualifying for Medicare and disability insurance. At times, she elected to forgo surgeries or appointments when she had to pay for the services upfront and could not. Along with the lack of Medicaid expansion, there is also a correlation between race and medical debt. In almost every state, people of color tend to have higher rates of medical debt, according to the Urban Institute data.
Residents in areas with high medical debt are also nearly twice as likely to be uninsured, according to an examination of U.S. Census Bureau data and Urban Institute data. Rising cost of care, insuranceThe rising cost of care in the U.S. is directly linked to medical debt, said Mark Rukavina, a program director for Community Catalyst, a Boston-based health advocacy organization.
Scott Mosher did just that. Mosher, who lives in the western North Carolina city of Newton, chose not to enroll in workplace insurance because of the high cost. Mosher couldn’t afford the deduction because he needed the money to get by, he said. When he started having prostate problems and pain in 2017, he didn’t seek medical care because he had no coverage.
Under the ACA, states are allowed to expand Medicaid eligibility to accept people with incomes of up to 138% of the federal poverty level. Without expansion, eligibility requirements to qualify for Medicaid are more stringent. “I was trying to get Medicaid or something, but I couldn’t. I’m behind in everything,” Mosher said. “I was worried about getting my stuff shut down, my power and water, because I hadn’t worked for months" while hospitalized.It’s why RIP Medical Debt recently increased its income threshold for qualifying for debt relief from the organization, she said. In the past, someone had to make 200% of the federal poverty level to qualify. Now, it's 400%, Sesso said.
This year, the nation's three largest credit bureaus, Equifax, Experian and TransUnion, announced that, starting in 2023, medical debt under $500 would no longer affect consumer credit reports, according to the Consumer Financial Protection Bureau. Collection agencies call daily, Pender said. With constant calls and collection letters, people with unpaid medical debt are always worried about it, RIP Medical Debt’s Sesso said.
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