The United States spends more per capita on health care than any other large developed country — and without a single-payer national health care system, much of that spending is shouldered directly by the consumer. And with over 80,000 confirmed cases of coronavirus to date — more than any other country in the world — the high cost of medical care is a pressing concern for a growing number of Americans.

According to a 2018 survey published by the Financial Industry Regulatory Authority, or FINRA, 22.7% of American adults have unpaid medical bills that are past due. Other surveys have shown that medical debt is the No. 1 reason Americans would consider liquidating their 401(k) or other retirement savings, and that about two-thirds of all personal bankruptcies are tied to health care bills.  

24/7 Wall St. reviewed FINRA survey data to determine how many people are burdened with medical debt in each state. Depending on the state, the share of adults with overdue medical bills ranges from less than 15% to over 40%.

The states in which lower than average shares of residents are burdened with unpaid medical bills tend to have several factors in common. These states typically have lower uninsured rates, meaning a larger share of the population has medical coverage, which can make health care bills more manageable. Also, residents in these states have higher incomes, meaning more available resources to pay out-of-pocket costs. Here is a look at America’s richest and poorest states.

The consequences of being saddled with medical debt can be far-reaching. Americans living in states where a large share of the population is struggling to pay medical bills are often less likely to seek treatment for known medical problems because of financial concerns. The greater likelihood of residents forgoing necessary treatment may explain why in many of these states health outcomes, such as life expectancy, are worse than average. Here is a look at the least healthy city in every state.

Click here to see how many people in your state are burdened with medical debt
Click here to read our methodology