Summary

Unexpected Medical Bills

Twenty-six percent (26%) of Connecticut respondents received an unexpected medical bill in the past year. Unexpected bills can be a major contributor to health care debt. A national survey found that many medical debts come from one-time or short-term medical expenses, which are often unexpected, and that many households don’t have the cash to cover an unexpected $500 health care bill.¹

Among respondents with unexpected bills, those with employer-sponsored and individually purchased insurance (e.g., through the health care Marketplace) most frequently reported unexpected medical bills (32% and 38%, respectively), followed by respondents enrolled in HUSKY Health, the state Medicaid program (15%) and Traditional Medicare (23%).

Financial Burdens Due to Medical Bills

Many survey respondents have experienced financial burdens due to medical bills. Over one-third (37%) reported experiencing one or more of these struggles to pay their medical bills in the last year:

• 12%—Used up all or most of their savings
• 12%—Were contacted by a collection agency
• 12%—Were unable to pay for basic necessities like food, heat or housing
• 9%—Were placed on a long-term payment plan
• 8%—Racked up large amounts of credit card debt
• 9%—Borrowed money, got a loan or another mortgage on their home
• 3%—Asked for donations (GoFundMe campaigns)

Notably, the survey results found that respondents ages 25-34 reported the highest rates of medical cost burdens followed by those age 18-24. Similarly, Respondents of Color reported experiencing at least one of the above medical cost burdens more frequently than white, non-Hispanic respondents. Likewise, respondents with a disability or who live with a person with a disability also reported navigating medical cost burdens more frequently than respondents without a disabled household member, and respondents with coverage purchased independently reported the highest rates of the above burdens due to medical bills compared to respondents with all other insurance types (see Table 1).

Medical Debt and Health Insurance

In the absence of affordable care options, individuals may find themselves burdened by medical costs. In 2024, nearly 100 million Americans owed over $220 billion in medical debt.² Medical debt is largely driven by unaffordable bills: many Americans with private coverage must pay thousands of dollars in out-of-pocket expenses to get care, including increasingly high premiums, deductibles, co-insurance, and copayments.^3,4,5 This lack of affordability is reflected in national survey findings that roughly half of adults say they could not pay a $500 unexpected medical bill, and would either have to incur debt to pay it or would not be able to pay the bill at all.⁶ These factors contribute to the rising amount of medical debt that many Americans face, which negatively impacts long-term financial security and ability to afford care in the future.

Medical debt is an issue for Connecticut survey respondents as well: 23% of respondents reported that they or a family member had outstanding medical bills. Among those with outstanding medical bills, the most common amount of medical debt reported was $1,000-$2,499, reported by twenty-nine percent of respondents. The next most frequently cited amounts were less than $500 (21%) $2,500 – $4,999 (17%), $5,000 – $7,499 (15%), and $500-$999 (13%). Still, 9 respondents (2%) report owing over $10,000 in medical debt. The duration of medical debts varied, with the largest share having a medical debt in their family for less than a year (49%) followed by 1-2 years (33%) and 3-5 years (14%).

Medical debt affects both insured and uninsured people (see Table 2). Medical debt can be common among uninsured people in part because they are responsible for the full cost of care.^7,8 Those with employer-sponsored, individual, and marketplace insurance may also be exposed to medical debt through high cost-sharing.⁹ While Medicaid and Medicare enrollees often have low or no cost-sharing, they may have fewer covered services, such as dental care, or a lack of providers who will accept their insurance, requiring them to pay out-of-pocket. ^{10, 11} All of these factors can contribute to medical debt across insurance types.

Over four in five (82%) of those with medical debt had health insurance at the time they incurred the debt. At the time of the survey, nearly half (46%) reported being covered by employer-sponsored insurance, followed by Traditional Medicare (10%), Medicare Advantage (15%),  insurance bought on the Marketplace exchange (8%), and HUSKY Health (15%). Three in four respondents (87%) had no gaps in coverage in the past 12 months.  

When asked why they incurred medical debt, over half (59%) of all respondents reported incurring medical debt because their insurance only covered a portion of the service, and the remaining bill was too high; followed by their insurance didn’t cover the service at all (16%), the deductible was too high and they were unable to meet it (14%).

Respondents most frequently identified the following services as the source of their medical debt:

• 68%—Hospital
• 28%—Doctor or technician in hospital
• 28%—Doctor or technician not in hospital
• 28%—Laboratory (lab tests, x-rays, scans)
• 21%— Urgent care centers

In lesser numbers, people selected dentist or dental provider (17%), pregnancy-related expenses (8%), physical therapist or pain management clinic (8%) and mental healthcare or addiction treatment (6%) as the source of their medical debt. 

Differences in Amount and Reasons for Medical Debt

Medical debt affects consumers across incomes, age groups, and other demographic characteristics; however, there are differences in the prevalence of medical debt across groups (see Table 6), as well as the amounts and reasons for incurring medical debt.

Income

Those earning between $50,000 and $75,000 reported the highest rates of medical debt, followed by those earning between $75,001 and $100,000 (see Table 3). Respondents with household incomes of less than $50,000 per year most often report having $2,500 or less in medical debt. Interestingly, respondents with household incomes above $100,000 per year also most often report owing $2,500 or less in medical debt.

Medical debt affects people across the income spectrum. While medical debt is most prevalent among low- and middle-income households, even high-income households are exposed to medical debt for similar reasons, including being unable to afford medical bills and expecting insurance to pay for services.¹²

Age

Respondents of different ages reported different incidence of medical debt. Those ages 25-34 reported the highest rates of medical debt, followed by those ages 35-44 (see Table 4).

Nationally, rates of medical debt are higher among middle age and young adults, who are more frequently exposed to the combined high cost of care for themselves, children, spouses, and aging relatives.¹³ Studies have also found that large shares of non-elderly households cannot afford to pay typical cost-sharing amounts, especially those with low incomes.¹⁴ Medical debt impacts long-term financial security, with many adults delaying buying homes and education.¹⁵

Although the prevalence of health care debt can decline with age, one in five adults ages 65 and older still have medical debt nationwide, with roughly one-third taking money out of retirement, college, or other long-term savings accounts.¹⁶ In addition, adults of all ages have reported medical debt negatively impacting their credit scores.¹⁷ These conditions can make it more difficult for adults of all ages to afford needed care in the future.

This may be reflected in Connecticut respondents’ rates of worry about their ability to afford health care in the present and the future. Respondents ages 35-34 reported the highest rates of lacking confidence they having enough money to pay for a major unexpected illness or injury (70%).

Interestingly, worry about affording the cost of nursing home or home care services and medical costs when elderly was most frequently reported by younger respondents: 63% percent of respondents between the ages of 25-34 and 72% of respondents aged 45-54 reported being worried about affording medical care when elderly, and 69% of all respondents under the age of 65 reported being concerned about affording nursing home or home care costs. This could suggest that Connecticut respondents may be worried about affording the cost of care for both themselves and aging relatives.

Disability

Some of the highest rates of medical debt were seen among households that include a person with a disability. Respondents whose households included a member with a disability reported higher rates of medical debt for themselves or their family (29%) compared to those without a disabled household member (21%) (see Table 5). Respondents with a disabled household member most frequently reported owing up to $5,000 in medical debt (25%), while those without a disabled household member most frequently reported medical debt up to $2,500.

While medical debt occurs across demographic groups, people with disabilities and health issues often report higher rates of medical debt.¹⁸ People with complex health needs require ongoing care and can incur high out-of-pocket costs as a result.¹⁹ They may also experience unemployment and income loss, further impacting their ability to afford medical bills.²⁰

Race and Ethnicity

Differences in medical debt exposure were also seen across racial/ethnic groups. Respondents of color reported higher rates of medical debt (28%) compared to White alone non-Hispanic respondents (18%) (see Table 6).

Support for Solutions Across Party Lines

The burden of health care costs and the widespread support for solutions indicate that policymakers can prioritize addressing these consumer challenges. Connecticut respondents endorsed several strategies, including:

• 90% — Limit the price of expensive prescription drugs; 
• 90% — Prohibit extra fees that aren’t connected to the cost of your care, like hospitals charging facility fees at offices and clinics miles away from the hospital campus; 
• 89% — Rein in how quickly prescription drug prices can increase in the private health insurance market (Medicare and Medicaid already do this); 
• 89% – Increase investment in primary care;

• 89% – Prevent hospitals from charging more for routine health care services that are most often provided in a doctor’s office;
• 87% – Integrate the Medicaid and Medicare programs for people who are eligible for both to make it simpler for them to navigate those programs;
• 87% – Limit the prices at expensive hospitals in the private health insurance market (Medicare and Medicaid already set hospital prices for their markets); 
• 86% – Change the way we pay doctors and hospitals to reward quality outcomes rather than quantity of services; 

• 86% – Make it easier for people to apply for and renew their Medicaid coverage; 
• 83% — Allow the government to limit and prevent health care mergers that could reduce competition and increase health care prices; and 
• 81% – Allow your pharmacist to substitute for a lower cost prescription drug option, if available, without needing to get permission from your prescriber.

In addition, 82% of respondents thought that it was moderately or extremely important for the state to maintain or in some cases expand Medicaid funding to prevent medical debt and improve access to care for those who need it most. Support for solutions extended across the aisle, reflecting bipartisan agreement on the need for greater health care price transparency and policies designed to reduce the frequency of unexpected medical bills and out-of-pocket costs (see Table 7). It must be noted that, although price transparency tools can help identify unwarranted price variation, these tools alone do not make markets more efficient and generally fail to encourage consumers to shop for lower-priced services.²¹ Instead, policymakers may consider a combination of transparency tools and evidence-based policies to effectively address these issues.

Conclusion

Connecticut respondents report receiving unexpected medical bills that are often higher than anticipated. In some cases, respondents experienced financial burdens to pay their medical bills, such as using up all their savings and going without other necessities. In other cases, respondents were unable to pay and had outstanding bills resulting in medical debt, or experienced other financial burdens due to medical bills such as credit card debt, loans, and bills going to collections. Respondents largely incurred medical debt due to unaffordable out-of-pocket costs. The majority had health insurance, and most reported incurring medical debt because their insurance plan did not cover the service, or because their deductible or co-insurance was too high and they could not afford to pay it.

Respondents across the political spectrum expressed support for policies to increase health care price transparency and curb excess prices that could lead to high out-of-pocket costs. However, while some system level changes can reduce prices and make them more transparent to consumers, if the resulting costs remain unaffordable for consumers, medical debt will continue to be an issue. Given the financial impacts of high medical bills and medical debt, state policymakers can use these insights to investigate policies that protect consumers from unaffordable out-of-pocket costs and prevent medical debt before it occurs. For more information on healthcare affordability in Connecticut and strategies that survey respondents support, please see the [Connecticut Health Care Affordability Consumer Healthcare Experience State Survey].