Medical Debt Drives Delayed Healthcare, Even Among Insured

Medical debt is significantly linked to delayed dental, medical, and mental healthcare, even for individuals with health insurance, according to a recent study by researchers at the Johns Hopkins Bloomberg School of Public Health. The findings highlight a growing public health concern, particularly as policy changes potentially exacerbate financial barriers to care.

The Link Between Debt and Deferred Care

The study, based on data from the 2023 National Health Interview Survey encompassing nearly 30,000 U.S. Adults, revealed substantial disparities in care deferral rates between those with and without medical debt. Specifically:

• Dental Care: 42.3% of individuals with medical debt delayed dental care, compared to 17.7% of those without – a 2.4 times higher rate.
• Medical Care: 23.0% of those with medical debt postponed medical care, versus 5.3% of those without, representing a 4.3 times increase.
• Mental Health Care: 14% of individuals with medical debt delayed mental health services, compared to 5% of those without – nearly three times as many.

Insurance Coverage and Medical Debt

The research likewise indicated that uninsured adults were more likely to defer medical care when burdened with medical debt compared to those with commercial insurance, Medicaid, or Medicare. Reported rates of medical debt were as follows:

• Uninsured: More than 19%
• Medicaid: 13%
• Commercial Insurance: 9%
• Medicare: 8%

Notably, the study found comparable rates of deferred care for both mental health and dental needs among insured and uninsured individuals.

Policy Implications and Future Concerns

Researchers emphasize that delaying care can lead to poorer health outcomes, increased mortality rates, and greater reliance on costly medical interventions that could have been avoided with preventative care. The study authors suggest that recent policy developments, including cuts to insurance coverage in the 2025 Budget Reconciliation Act , may worsen medical debt and its associated consequences. ,

“Addressing spiraling medical debt is critical to mitigating the health and economic impacts of treatment delay,” said Kyle Moon, a doctoral candidate at the Bloomberg School’s Department of Mental Health.

Study Limitations

The authors acknowledge certain limitations within the study. The reliance on self-reported financial burdens and deferred treatment data may not fully capture the extent of medical debt and could be subject to recall bias.