TALES FROM THE ATTIC

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MULTITUDES: The unauthorized memoirs of Sam Smith

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October 9, 2026

Health

What healthcare is really costing us

Axios - More than a quarter of Americans say they or their families were saddled with medical debt in 2025, including many with health insurance, according to a new Urban Institute study. The findings are an indicator of just how unaffordable care has become — and how having insurance is no longer a buffer against expensive medical bills.

Medical debt plagues higher proportions of the uninsured. But just 7.9% of Americans went without coverage last year.

  • A growing number of Americans with workplace coverage or individual policies are finding they can't afford deductibles, copays or other out-of-network costs.

Medical debt has taken center stage in what's turned into a surprisingly competitive Senate race right in the heart of Trump country.

  • Sen. Roger Marshall (R-Kan.) filed lawsuits against more than 700 patients with outstanding medical bills throughout his career as an obstetrician-gynecologist, the New York Times reported last month….

By the numbers: 26.6% of Americans reported they or their family members owed medical debt as of December, the Urban Institute found in a survey of more than 10,000 adults.

  • Medical debt was most common among adults 45 to 54, those who are Black, Hispanic, or in racial groups other than white or Asian, and those with incomes 100%–200% of the federal poverty level.
  • 17.6% of seniors eligible for Medicare coverage reported that they or a family member owed medical debt.
  • More than half of adults with medical debt reported owing $1,000 or more, and 15.5% owed $5,000 or more.
  • More than 4 in 10 adults with disabilities had medical debt, as did 42% of those who reported being in fair or poor health….

Affordability challenges are poised to get worse, not better.

  • Republicans' cuts to federal Medicaid spending and the expiration of enhanced Affordable Care Act tax subsidies are expected to increase the uninsured rate. Other individual market enrollees will face higher premium costs.
  • Meanwhile, employers are staring down yet another year of high medical cost growth, much of which will likely get passed on to workers via higher premium or out-of-pocket obligations.
  • Concern over medical debt is going viral, with some social media influencers urging their followers to refuse to pay large bills, or to ask for itemized versions and whether they qualify for financial assistance, the Wall Street Journal reported.

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