The Medical Debt Crisis: 100 Million Americans and Counting

According to the Kaiser Family Foundation, approximately 100 million Americans — nearly 1 in 3 — carry some form of medical debt. It's the leading cause of bankruptcy in the United States, contributing to roughly 65% of all personal bankruptcy filings.

The crisis isn't distributed evenly. States without Medicaid expansion tend to have significantly higher rates of medical debt. In the Southeast, medical debt rates can exceed 25% of the adult population. In states with expanded Medicaid and stronger consumer protections, rates drop below 10%.

TrueCost tracks this data across all 50 states, including debt rates, bankruptcy filings, Medicaid expansion status, and links to state-specific assistance programs. Our advocacy tools make it easy to find and contact your elected officials.

But the root cause isn't just insurance coverage — it's price opacity. When hospitals can charge whatever they want and patients can't comparison-shop, prices spiral. The No Surprises Act of 2022 requires hospitals to publish their prices, but the data is often buried in machine-readable files that consumers can't use.

That's where tools like TrueCost come in. By translating Medicare data into fair cash prices and giving patients negotiation leverage, we're attacking the problem at the transaction level — one procedure, one bill, one conversation at a time.

The system won't change overnight. But every patient who negotiates a fair price creates pressure on the system to be more transparent. And that's a start.