The trend: Patients are struggling to afford their medical bills, and it’s not just limited to lower-income and uninsured individuals, according to a March 2026 report from Cedar based on survey responses from 4,150 US adults and insights from 1.5 billion patient interactions.

• 40% of patients who have difficulty paying medical bills have household incomes above $100,000, including 10% with incomes exceeding $200,000.
• About 25% of commercially insured patients have trouble paying medical bills.

Why this is happening: To protect their margins, many insurers are tightening coverage and shifting more consumers into high-deductible health plans, which require members to pay the full cost of most medical care (which can be exorbitant) until they meet their deductible.

Regardless of deductibles, consumers are facing high rates of coverage denials: 21% of those with commercial insurance said they or a family member had been denied coverage in the past year for doctor-recommended medical care, per a June 2026 Commonwealth Fund report.

Why it matters: Difficulty paying medical bills can force patients to choose between paying healthcare bills and cutting back elsewhere, or delaying payment and taking on debt.

One-third of US adults say they have made sacrifices to cover healthcare expenses, including borrowing money, skipping meals, or driving less, according to a March 2026 West Health-Gallup survey. Meanwhile, an estimated 20 million US adults carry medical debt, with about 14 million owing over $1,000, per the Peterson-KFF health system tracker. Medical debt is the third most common form of debt among people with outstanding balances, trailing only credit card debt and auto loans, according to a March 2026 Northwestern Mutual report.

Implications for healthcare providers: The consequences of medical debt (and of not paying medical bills) can be severe, ranging from debt collection and personal bankruptcy to being denied future care by the provider until an outstanding balance is paid. The reverse can also happen: patients may forgo needed care altogether because they know they can't afford another bill. Many provider organizations offer payment plans for large medical bills, but those arrangements often come with drawbacks, including high interest rates, deferred-interest penalties, and strict late-payment policies.

Providers should instead show patients what they are likely to owe before care begins. That means offering upfront cost estimates based on insurance coverage, verifying benefits before appointments, clearly explaining deductibles, copays, coinsurance, and out-of-network costs in plain language, and connecting patients with financial counseling early in the process. These steps won't eliminate medical debt or lower the cost of care, but they can build trust, reduce financial surprises, and set realistic expectations from the outset.