ICYMI: Medical Debt Burden Highest in States That Haven’t Expanded Medicaid

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WASHINGTON — According to a new study, Americans’ medical debt has grown to over $140 billion, becoming the largest source of debt collections in the country and larger than previously known. The burden is disproportionately concentrated in the Republican-led states that have yet to expand Medicaid, a stance that denied affordable health care coverage to millions of Americans. 

“It seems like every week there is a new reason that underscores why Republican politicians should put partisanship aside and expand Medicaid,” said Democratic Legislative Campaign Committee President Jessica Post. “Extending access to affordable coverage wouldn’t solve all the problems in our broken health care system, but it would be a start. GOP leaders need to stop playing games and finally do what they should have done long ago.”

Opposition to Medicaid expansion runs so deep among Republican legislators that they have resorted to antidemocratic tactics to stop it; Missouri Republicans refused to implement the policy earlier this year even though voters passed a constitutional amendment to that effect last year. GOP legislators across the country refused to pass Medicaid expansion, despite new incentives under the American Rescue Plan for them to do so. 

New York Times: Americans’ Medical Debts Are Bigger Than Was Known, Totaling $140 Billion

Americans owe nearly twice as much medical debt as was previously known, and the amount owed has become increasingly concentrated in states that do not participate in the Affordable Care Act’s Medicaid expansion program.


The ameliorating effects of Medicaid expansion were not a big surprise to the paper’s authors. Previous research demonstrated how Medicaid coverage can reduce medical debts. In states that have expanded, most low-income adults can get coverage without paying premiums, and with minimal cost sharing. Mechanically, Medicaid tends to eliminate the kinds of medical bills that result in outstanding debts.

But Mr. Mahoney said he was shocked to see the widening inequality in medical debt that disparate state decisions appear to have caused. The states that have declined to expand Medicaid — particularly in the South — started out having more medical debt before Obamacare passed, and since other states have expanded Medicaid, the chasm has grown wider.