Special Report

How Many People in Your State Are Burdened With Medical Debt?

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31. New Mexico
> Adults with unpaid med. bills: 243,748 (15.1% of adult pop. — 3rd lowest)
> Median medical debt in collections: $731 (22nd highest)
> Uninsured rate: 9.5% (16th highest)
> Adults in fair or poor health: 20.8% (7th highest)

Most states with relatively low incomes and high uninsured rates are also home to relatively larger shares of adults with unpaid medical bills. But New Mexico is an exception. The median annual household income in the state is $47,169, and 9.5% of state residents are uninsured. Meanwhile, the median household income nationwide is $61,937, and 8.9% of the U.S. population does not have health insurance. Still, just 15.1% of adults in New Mexico have unpaid medical bills, well below the 22.7% share of adults nationwide.

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32. New York
> Adults with unpaid med. bills: 2.7 million (17.7% of adult pop. — 10th lowest)
> Median medical debt in collections: $446 (5th lowest)
> Uninsured rate: 5.4% (9th lowest)
> Adults in fair or poor health: 16.1% (24th highest)

There are 2.7 million adults in New York state with unpaid medical bills, or 17.7% of the 18 and older population — a smaller share than in most states. As is often the case where relatively small shares of adults have medical debt,

New York has high incomes and relatively more residents with health insurance coverage. The median annual household income in the state is $67,844 a year, and 5.4% of state residents are uninsured. Meanwhile, the median household income nationwide is $61,937, and 8.9% of the U.S. population does not have health insurance.

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33. North Carolina
> Adults with unpaid med. bills: 2.2 million (27.0% of adult pop. — 11th highest)
> Median medical debt in collections: $698 (24th highest)
> Uninsured rate: 10.7% (9th highest)
> Adults in fair or poor health: 17.6% (18th highest)

North Carolina is one of only 14 states not to have adopted Medicaid expansion. Partially as a result, North Carolina’s 10.7% uninsured rate is one of the 10 highest among all states. Health insurance takes a considerable financial burden off the patient, and North Carolina’s high uninsured rate likely helps explain why a higher than average share of adults have unpaid medical bills, at 27.0%.

While North Carolinians are more likely than most Americans to have medical debt, those with debt do not typically have more of it. The median amount of medical debt that has been turned over to collections agencies in the state is $698, in line with the comparable national median.

34. North Dakota
> Adults with unpaid med. bills: 119,234 (20.3% of adult pop. — 18th lowest)
> Median medical debt in collections: $624 (22nd lowest)
> Uninsured rate: 7.3% (22nd lowest)
> Adults in fair or poor health: 14.3% (15th lowest)

In North Dakota, 20.3% of residents 18 and older have unpaid medical bills, a smaller share than in most states. Still, North Dakota residents are less likely to seek treatment for a medical problem due to medical costs than the typical American.

The lower likelihood of medical debt among adults in North Dakota may be attributable to less frequent treatment, as state residents are more likely to have better assessments of their own health than Americans on average. For example, just 14.3% of adults in the state report being in fair or poor health, compared to 16.0% of American adults nationwide.

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35. Ohio
> Adults with unpaid med. bills: 2.2 million (24.4% of adult pop. — 23rd highest)
> Median medical debt in collections: $531 (15th lowest)
> Uninsured rate: 6.5% (18th lowest)
> Adults in fair or poor health: 17.0% (22nd highest)

Ohio residents age 18 and up are slightly more likely than the typical American adult to be saddled with unpaid medical bills. Although Ohio residents are more likely to have health insurance coverage, even with insurance, health care can come with considerable out-of-pocket costs — and people in Ohio are more likely to have limited financial resources. The typical household in the state earns $56,111 a year, nearly $6,000 less than the typical American household.

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