KFF estimated $220 billion in medical debt in 2024 as nonprofit relief accelerated
Medical-debt relief has accelerated in the United States this year, and some of the millions of Americans who collectively owe billions of dollars for medical expenses have had their debt forgiven in recent years. Undue Medical Debt states that it has provided $53.3 billion in medical-debt relief, with about half provided this year, while KFF estimated that people owed at least $220 billion in medical debt in 2024. Experts say the relief covers only a small fraction of the outstanding balance and does not solve the fundamental problem: people get into serious financial trouble because they cannot afford the healthcare they need.
Undue Medical Debt, founded in 2014 by former debt-collection executives, helps address the problem by purchasing large portfolios of debt from healthcare organizations and collection agencies at a steep discount. According to the organization, a $1 donation erases about $100 of medical debt. The nonprofit does not accept requests from individuals, but people who earn four times the federal poverty level or less, or whose medical debt is 5% or more of their annual income, are eligible for relief.
Undue Medical Debt states that it has provided $53.3 billion in medical-debt relief, with about half provided this year, and attributes that increase to its investment in technology that allows it to process files more quickly and to increased partnerships with governments. Recipients of Undue Medical Debt relief receive a notice that the balance has been absolved, in contrast to the original bills sent by providers. “I am hopeful everyone that receives a letter feels more comfortable going back to the doctor and getting the care that they need and are not scared about the financial consequences,” said Allison Sesso, the organization’s president and CEO.
Sesso called financial assistance a “stopgap for people that need help today” and said: “We have set up a system that incentivizes profits over people.” Mary Shannon, director of Care Over Collections, a nonprofit that educates patients who receive bills about their options, said: “Addressing the affordability crisis in healthcare is what will ultimately get at the heart of the issue.”
KFF, a nonprofit health research group, estimated that people in the United States owed at least $220 billion in medical debt in 2024. About 14 million owed more than $1,000, and 3 million people owed more than $10,000. Emma Wager, KFF senior police analyst, said: “Costs are very high, and some people have no health insurance, so when they get sick or injured or need healthcare, they have no way to pay the extremely high charges.” Even people with insurance often have high deductibles or high cost-sharing provisions in their plans, which means they could still find the bills unaffordable, Wager said.
Other organizations work on the same problem. Dollar For, another nonprofit, allows patients to apply for financial assistance to forgive or reduce their medical debt and has provided more than $117 million, according to the organization. The HealthWell Foundation helps with prescription copays and insurance premiums and deductibles, among other expenses. The Community Service Society of New York has successfully advocated for state legislation such as the Fair Medical Debt Reporting Act, which prohibits hospitals and providers from providing consumer reporting agencies information about a patient’s medical debt.
Undue Medical Debt receives funding from private donors and state and local governments. Illinois provided $10 million to the organization, which used the funds to provide more than $1.1 billion in medical-debt relief for Illinois residents, according to the state.
Patients often fall behind on their payments. In 2024, 21% of US households had a past-due medical bill, according to the journal Health Affairs Scholar. In 2021, more than half of the bills sent to collectors were for medical care, according to the Consumer Financial Protection Bureau.
Federal law requires nonprofit hospitals to establish a financial-assistance policy but does not specify minimum eligibility requirements. The Commonwealth Fund, a nonprofit that studies health care issues, said 18 states have gone further and require all hospitals, including for-profit ones, to offer financial assistance with minimum eligibility standards.
Six states also have “presumptive eligibility” laws, which require hospitals to screen patients to determine whether they qualify for assistance and, if so, proactively erase the debt, KFF Health News reported.
Access to those programs remains uneven. In Missouri, almost all general hospitals offer free or discounted care, but less than a quarter of adults said they received information about the programs from a provider, according to a 2025 study from the Missouri Foundation for Health and the Lown Institute. Advocates argue that providers must do more to make patients aware of the financial assistance they offer.
The Biden administration also passed a rule banning the inclusion of medical debt on credit reports, but the Trump administration and trade groups asked a federal court to block the measure, which a judge did. The Commonwealth Fund said 16 states prohibit or restrict the inclusion of such debt on credit reports.
“It has a major impact on people’s credit ratings,” said Sara Collins, Commonwealth senior scholar for expanding coverage and access. “People have healthcare problems that are not their fault, and yet they are being saddled with medical debt because they don’t have the coverage to pay it off.”
Tiffany Miller’s experience shows how debt can follow serious illness even for an insured patient. In 2019, Miller was 26 weeks pregnant when she went into labor. Her daughter, Brie, spent more than three months in a neonatal intensive care unit and then required physical and occupational therapies. Miller, a mental health caseworker, had insurance, but she still accumulated more than $2,000 in debt.
“I’m a very faith-based person, so I had just been praying a lot because a lot of this debt was on my credit report,” said Miller, 40, who lives in Aurora, Illinois. In May, she received a letter from Undue Medical Debt informing her that the debt had been erased. She thought it was a scam, did some research and learned the relief was real. Brie is now a healthy seven-year-old. Harris said: “It just felt like those financial weights that have accumulated over the years, like a couple of them were taken off.”