Medical Debt Drives Delayed Healthcare, Even Among Insured Americans

Medical debt is significantly associated with delaying necessary healthcare, including dental, medical, and mental health services, even for individuals with health insurance, according to a new study from the Johns Hopkins Bloomberg School of Public Health. The research highlights a critical public health concern, demonstrating that financial barriers to care impact access across all insurance types.

The Link Between Debt and Deferred Care

The study, published in the Journal of General Internal Medicine on March 10, 2026, analyzed data from the 2023 National Health Interview Survey, encompassing nearly 30,000 U.S. Adults. Researchers found that over 10% of participants reported medical debt – defined as difficulty paying medical bills in the past year.

The findings reveal a stark disparity in care deferral rates:

• Dental Care: 42.3% of individuals with medical debt delayed dental care, 2.4 times higher than those without debt.
• Medical Care: 23% of those with medical debt postponed medical treatment, a fourfold increase compared to the 5.3% rate among those without debt.
• Mental Health Care: 14% of individuals burdened by medical debt delayed mental health services, nearly three times the 5% rate observed in those without debt.

Impact Across Insurance Types

Medical debt prevalence varied by insurance status: 19.5% among the uninsured, 12.6% with Medicaid, 9.3% with commercial insurance, and 8.1% with Medicare [1]. While the association between medical debt and deferred care remained consistent across insurance categories, the impact on delaying medical care was significantly higher among uninsured adults compared to those with commercial insurance.

Why Dental Care is Most Affected

The study suggests that dental care is particularly sensitive to medical debt, potentially because it’s often not fully covered by standard health insurance plans, frequently requiring separate, limited-coverage insurance [3].

The Broader Consequences of Delayed Care

Delaying healthcare, whether preventative or treatment-focused, can have serious consequences. It can lead to missed opportunities for early detection and management of health issues, potentially worsening conditions and increasing long-term costs for patients, insurers, and the healthcare system as a whole [1]. Poor dental health, for example, is linked to heart disease and cognitive decline.

Policy Implications

Researchers emphasize that recent policy changes, such as potential cuts to insurance coverage, could exacerbate medical debt and its associated consequences [2]. Addressing affordability and the broader impact of medical debt is crucial for mitigating the health and economic repercussions of deferred care. As Kyle Moon, the study’s first author, stated, “Policies that address affordability and the cascading toll of medical debt are critical to mitigating the health and economic impact of deferred care.”

Study Limitations

The study acknowledges certain limitations, including reliance on self-reported data for medical debt and deferred care, which may be subject to recall bias.

Key Takeaways

• Medical debt is a significant barrier to healthcare access, even for those with insurance.
• Dental care is the most frequently deferred type of care among individuals with medical debt.
• The impact of medical debt on delaying medical care is more pronounced among the uninsured.
• Addressing medical debt is crucial for improving public health and reducing healthcare costs.

Source: Moon, K. J., et al. (2026). Medical Debt and Deferred Care for Physical Health, Mental Health, and Dental Needs Among U.S. Adults. Journal of General Internal Medicine. DOI: 10.1007/s11606-026-10215-x