Medical debt and collections in the United States.

Introduction: Medical debt and collections are common and large, but estimates differ widely.

Methods: We used 2 nationally representative surveys in 2024 that are associated with respondents' credit records to measure medical debt and medical collections from survey participants directly and compare their responses with the medical collections reported to the credit bureau.

Results: In 2024, 36% of US households had medical debt, 21% had a past-due medical bill, and 23% were paying a medical bill over time to a provider. Medical and dental providers are thus one of the most common sources of credit to households. At the same time, 15% of people were contacted by someone other than their medical provider to collect a medical debt while only 12% had any medical collection on their credit record and 5% had a new collection. Active medical collections only partially overlap with medical collections on credit reports and neither represents all medical debt. We bound the mean total debt in active medical collection for people with such collections as between $2456 and $7931.

Conclusion: These debts are not interchangeable, so future policy and research should distinguish carefully between them.