Special Report

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

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36. Oklahoma
> Adults with unpaid med. bills: 798,111 (26.7% of adult pop. — 14th highest)
> Median medical debt in collections: $857 (7th highest)
> Uninsured rate: 14.2% (2nd highest)
> Adults in fair or poor health: 19.6% (9th highest)

Oklahoma is one of only 14 states not to have adopted Medicaid expansion through the Affordable Care Act, and partially as a result, state residents are less likely to have health insurance. Oklahoma’s uninsured rate of 14.2% is the second highest of any state and well above the comparable nationwide rate of 8.9%. Americans seeking medical treatment without health insurance have considerably higher out-of-pocket expenses, and in Oklahoma, 26.7% of adults have unpaid medical bills, well above the 22.7% of American adults nationwide who do.

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37. Oregon
> Adults with unpaid med. bills: 672,365 (20.3% of adult pop. — 17th lowest)
> Median medical debt in collections: $647 (23rd lowest)
> Uninsured rate: 7.1% (20th lowest)
> Adults in fair or poor health: 15.8% (24th lowest)

Oregon residents are more likely to have health insurance coverage and higher incomes than the Americans nationwide. Partially as a result, just 20.3% of adults in the state have outstanding medical bills, a smaller share than in most other states.

Still, even with health insurance, trips to the doctor, emergency room, or a clinic can come with high out-of-pocket costs. In the last year, 21.1% of adults in Oregon have had a medical problem yet not sought treatment due to the cost, slightly higher than the 20.6% of adults nationwide.

38. Pennsylvania
> Adults with unpaid med. bills: 2.1 million (21.1% of adult pop. — 20th lowest)
> Median medical debt in collections: $512 (14th lowest)
> Uninsured rate: 5.5% (11th lowest)
> Adults in fair or poor health: 15.1% (19th lowest)

Likely due in part to a lower than average uninsured rate, adults in Pennsylvania are less likely than most American adults to be saddled with medical debt. An estimated 21.1% of Pennsylvania residents 18 and older have unpaid health care bills — a slightly smaller share than the 22.7% of adults nationwide.

Pennsylvania residents are also less likely than most Americans to be deterred from seeking necessary medical treatment because of concerns over cost. Just 16.8% of adults in the state have opted to not get treatment in the last 12 months for a known medical problem because of cost, below the comparable share of adults nationwide of 20.6%.

39. Rhode Island
> Adults with unpaid med. bills: 146,634 (17.2% of adult pop. — 7th lowest)
> Median medical debt in collections: $468 (8th lowest)
> Uninsured rate: 4.1% (4th lowest)
> Adults in fair or poor health: 14.8% (17th lowest)

Like many other states in the Northeast, all of which have adopted Medicaid expansion under the Affordable Care Act, Rhode Island has a low uninsured rate. Just 4.1% of state residents are without health insurance, less than half the 8.9% national uninsured rate. Partially as a result, adults in the state are far less likely than Americans nationwide to be saddled with unpaid medical bills. Additionally, Rhode Island residents are less likely than the average American to be deterred from seeking necessary medical treatment due to concerns related to cost.

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40. South Carolina
> Adults with unpaid med. bills: 1.3 million (31.4% of adult pop. — 2nd highest)
> Median medical debt in collections: $787 (14th highest)
> Uninsured rate: 10.5% (11th highest)
> Adults in fair or poor health: 19.1% (11th highest)

A staggering 31.4% of adults in South Carolina have unpaid medical bills, the second largest share of any state. The prevalence of medical debt is likely due in large part to the high uninsured rate in the state, which is exacerbated by low incomes. The median annual household income in the state is $52,306, and 10.5% 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.

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