Commonwealth Fund Survey Shows Increase in National Medical Debt


More than half of U.S. adults who contracted COVID-19 or lost income during the pandemic also struggled with medical debt.

8/3/2021 8:00

After over a year of severe job market disruption in the wake of the COVID-19 pandemic, combined with a massive pandemic relief effort from the federal government, Americans are left wondering where the state of health care coverage and affordability lies.

To find out, The Commonwealth Fund, in partnership with survey research firm SSRS, conducted the Health Care Coverage and COVID-19 Survey March 9 through June 8, 2021using a nationally representative sample of 5,450 adults ages 19 to 64.

Although the COVID-19 pandemic caused a significant economic recession that left millions of people without work , early Commonwealth Fund findings based on federal data and unemployment claims indicated that coverage losses were relatively low, according to the survey report from the Commonwealth Fund.

Despite this, plenty of Americans have suffered in immeasurable ways, especially those who either lost their jobs or contracted COVID-19, resulting in loss of employee coverage or income and leaving many with increased medical debt.

Survey Highlights:

  • About 10% of adults ages 19 to 64 were uninsured during the first half of 2021. Rates were higher among Latinx/Hispanic and Black adults compared to white adults.
  • Six percent of working-age adults reported they lost their employer health coverage due to unemployment related to the pandemic; of those, 67%  found other coverage.
  • Just under half of respondents reported they had been directly affected by the pandemic in at least one of three ways: getting COVID-19, losing income, or losing employer health coverage. One-third reported lost income.
  • More than one-third of insured adults and half of uninsured adults reported they had problems paying medical bills or were paying off medical debt during the prior year. These rates were similar to those found in Commonwealth Fund surveys conducted prior to the pandemic.
  • People directly affected by the pandemic reported having medical bill and debt problems at higher rates than those not directly affected.
  • Among respondents with medical bill and debt problems, 35% spent all or most of their savings, 35% took on credit card debt, 27% were unable to pay for basic necessities like food or rent, and 23% delayed education or career plans.

People with either public or private insurance when the survey was conducted reported issues with medical bills or debt (some may not have had coverage for the full year), according to the Commonwealth Fund.

Insurance plans requiring deductibles have become more common, and the size of deductibles has grown as well, leaving increasing numbers of privately insured people exposed to potentially high costs. 

“The [Affordable Care Act’s] minimum benefit requirements and preexisting condition protections, along with cost-sharing subsidies and limits on out-of-pocket costs, have significantly improved the coverage offered by plans sold in the individual market. But the greatest protections are aimed at people with the lowest incomes and are far less extensive for people farther up the income scale,” the report states.

For more information, read the Commonwealth Fund Health Care Coverage and COVID-19 Survey report and findings here.

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