COVID patients accruing medical debt

Lucrative federal funding falling short for many

Americans increasingly struggled to pay their medical bills during the pandemic because of being infected with the coronavirus, losing income or losing employer health insurance coverage, a new survey shows.

More than a third of insured adults and half of uninsured adults said they had difficulty paying for a medical bill. The national survey by the Commonwealth Fund between March and June 2021 asked 5,450 working-age adults about how the pandemic affected their health insurance coverage and medical debt.

“They suffered ruined credit ratings. They were unable to afford basic life necessities like food, heat or their rent,” said lead author Dr. Sara Collins, Commonwealth Fund’s vice president for health care coverage, access and tracking.

This trend has become a chronic problem in the U.S. health system, she said.

In 2005, the number of working-age Americans paying off medical debt hovered around the same rate as it is today, at 34%, according to survey data from the Commonwealth Fund. The amount of debt, however, rose 7% during the pandemic, according to a Credit Karma analysis. In an analysis of nearly 20 million Americans, they reported $45 billion of medical debt in collections.

The study also found insured rates stayed at around the same level, with the uninsured rate at 10%. The highest uninsured rates were among those with low income and Black and Hispanic adults, which had higher uninsured rate than white adults.

Insurance coverage losses were relatively small, at 6% of respondents. For those respondents, 67% gained coverage elsewhere, with a little more than half only lapsing in coverage for three or fewer months.

The study shows 16% of respondents who lost coverage were uninsured for more than a year.

Many health insurance companies waived copayments and other costsharing requirements for people with COVID-19, but a study by University of Michigan and Boston University researchers found even those with health insurance were hit with medical bills. Of 1,377 privately-insured patients hospitalized with COVID-19 last year from March through September, 71% were billed an average of $788 for out-of-pocket expenses not covered by insurance.

Since the beginning of the pandemic, Congress has authorized $186.5 billion for hospitals and other health providers to offset the costs of caring for COVID-19 patients who don’t have insurance. Of that amount, more than $117 billion has been paid to hospitals and other providers, a federal oversight website shows.

Still, the lucrative federal funding does not cover all costs hospitals incurred taking care of patients. Hospitals could collect funds only for patients with a primary diagnosis of COVID-19, so patients who sought care for other medical problems were not covered, Commonwealth Fund officials said.