A national Urban Institute analysis, backed by the Robert Wood Johnson Foundation, estimates that more than one in four U.S. adults reported medical debt for themselves or a family member in 2025. More than half of those households owed at least $1,000, and 26% of adults reporting debt carried current health insurance.
The study, announced by the foundation, also found that one in seven adults with medical debt had past-due bills or debts they could not pay. Adults 45 to 54 made up the largest group with medical debt; 17.6% of Medicare enrollees in the study also reported owing money. Hospital services were the most commonly cited source, named by 52% of adults with medical debt, followed by specialists, dental care and general doctor visits.
Separately, Health Policy Institute of Ohio researcher Brian O’Rourke pointed to Ohio Medicaid Assessment Survey data showing more than one in five Ohio adults had trouble paying medical bills in the past year. Uninsured Ohioans faced the greatest risk, but about one-quarter of privately insured state residents also struggled. O’Rourke said out-of-pocket spending in Ohio exceeds the national average.
HPIO has projected that federal Medicaid changes and reduced Affordable Care Act subsidies could affect coverage; it said the state’s ACA Marketplace enrollment has fallen by 100,000 and projects up to 300,000 Medicaid participants could lose coverage under new work requirements.
Ohio House Bill 257, introduced in May 2025 by Reps. Michele Grim, D-Toledo, and Jean Schmidt, R-Loveland, would cap medical-debt interest at 3% annually, bar methods such as wage collection and prevent providers or collectors from reporting nonpayment to consumer reporting agencies. The bill has had hearings and support from several health advocacy groups; collection and data industry groups oppose it. It must pass by December or be reintroduced.