FRESNO, Calif. – More than one in four U.S. adults say they or someone they know had medical debt last year – including people who had health insurance.
That’s according to a new analysis from the Urban Institute, a nonprofit public policy think tank, and the nonprofit philanthropic organization Robert Wood Johnson Foundation.
Of more than 10,000 adults aged 18 or older who responded to the organizations’ annual Well-Being and Basic Needs Survey, 27 percent reported having medical debt in December of 2025.
Among adults with health insurance, 26 percent reported having medical debt.
“The findings show that health insurance does not guarantee families can afford the care they need,” the report reads.
The cost of healthcare is among the top issues for voters in the Central Valley, a region with high enrollment in government-subsidized healthcare under Medicaid.
In 2025, U.S. House District 22, which covers parts of the southern Valley, reported the highest Medicaid enrollment rate of any Republican-held seat nationwide, at 64 percent. This is also a district where two candidates are trying to convince voters they both have solutions for the healthcare crisis.
Residents from Hanford, Visalia and Bakersfield have told KVPR in previous interviews that monthly premiums, prescriptions, and unexpected medical bills weigh heavily on them.
Recent federal policy changes to healthcare eligibility and enrollment are also kicking in. The federal government’s One Big Beautiful Bill Act laid out new rules around work-requirement documentation for certain adults starting in 2027. As a result of these eligibility changes, the California Health Care Foundation estimates 1.1 million people in California could lose coverage by 2030.
Researchers at the Urban Institute warn the cost of healthcare could worsen in the coming years. On top of that, more people could lose coverage.
For many families, the debt amounts to thousands of dollars. More than half of the survey respondents with medical debt said their families owed at least $1,000, while 16 percent said they owed upwards of $5,000.
In some cases, the financial burden wasn’t just the unpaid bill, according to the study.
Roughly 35 percent of adults said they or a family member had been contacted by a collection agency about their medical bills.
Overall, 15 percent of adults in the U.S. said they had family medical bills that were past due or that they were unable to pay altogether.
The study found that medical debt was more common among adults ages 45 to 54, as well as those with lower incomes, disabilities or those in fair or poor health.
Disparities in medical debt also fell along racial lines. About 38 percent of Black adults and 35 percent of Hispanic adults reported having debt, compared with 11 and 23 percent of Asian and white adults respectively.
Medical debt was also reported by nearly one in five adults aged 65 or older, even though nearly all people in that age group are enrolled in health coverage through Medicare.
Hospitals were the most common source of debt, with specialty services and dental care following close behind.
Editor’s note: This story mentions the California Health Care Foundation, a financial supporter of KVPR.
