Percy Evans, 66, sat across from his wife Beverly, 65, as she grimly shuffled through her unpaid medical bills while sitting at their kitchen table.
For Beverly the $11,000 in bills comes from a stroke and a subsequent knee surgery. They just added to an already precarious financial situation for the couple. Before her stay in the hospital, the Evanses were already struggling to pay off $1,100 monthly mortgage payments for their house.
“When I see her walking compared to 20 years ago, it’s a lot different,” Percy said in the six-part Al Jazeera documentary series Hard Earned. “She walks slowly and more cautious about her steps.”
Although insured their policy did not cover every expense and Beverly wracked up the debt since the couple declared bankruptcy after they both lost their jobs during the Great Recession.
She is far from alone. Nearly 20 percent of U.S. consumers — 42.9 million people — have unpaid medical debts, according to a December 2014 report by the Consumer Financial Protection Bureau (CFPB).
“Medical debt is incurred differently than other unpaid bills, such as unpaid phone or utility bills. Medical debt can result from an event that is unpredictable and costly, such as an accident or sudden illness,” the CFPB said. “In addition, consumers are often temporarily responsible for the whole bill until insurance works it out.”
“Complaints to the CFPB indicate that many consumers do not even know they owe medical debt until they get a call from the collections agency or they discover it on their credit report.”
A 2014 analysis by the financial planning company NerdWallet found that health care expenses comprised 38 percent of all debt payments received by third-party agencies. About half of all overdue debt mentioned on Americans' credit reports is from medical debt.
Consumer debt collected by third-party agencies, 2013
Medical debt is more problematic than other debt types because it often accrues without the patient's full knowledge. In addition, medical expenses are often owed out of sheer necessity for health care. Up until this year, when the major three credit-reporting agencies agreed to new policies to help those with medical debt, delinquency on medical debts could severely affect credit scores.
Since key provisions in the Affordable Care Act were passed in 2014, the share of adults with problems paying family medical bills fell 21.3 percent between September 2013 and March 2015.
But the problem is hardly fixed. In a newly released Federal Reserve report, 24 percent of respondents indicated that either they or their family members experienced financial hardship. Of those who experienced financial hardship, 35 percent report that either they or their spouse had lost a job. According to the same report, 31 percent of respondents report going without a doctor’s visit, prescription medicine or a visit to a specialist because they could not afford it. And among those with a household income of less than $40,000, 45 percent say they went without treatment in the preceding year.
Complaints to the CFPB indicate that many consumers do not even know they owe medical debt until they get a call from the collections agency or they discover it on their credit report.
Consumer Financial Protection Bureau
Nearly 50 percent of consumers do not have enough cash on hand to cover a $400 emergency expense.
“When people fall ill and end up at the hospital with unexpected bills, far too often they have entered into a financial maze,” CFPB director Richard Cordray said in a speech last year in Oklahoma City.
For the Evans' any hopes of trying to pay off their medical debts lie in getting new jobs or pay rises. But that is not likely to be easy. Percy lost his $45,000-a-year job as a maintenance worker during the Great Recession and now makes $10.50 an hour as a night janitor. Beverly is retired after the social services company she worked for folded, but is considering finding a part-time job at a time when other people might be looking forwards to retirement.
“My mother shouldn’t even have a conversation about finding a part-time job,” said Beverly’s son, Keith Briggs.
“She knows she physically can’t do it, but when you look at your table scattered with bills and people that you owe, the only option is to think about going back to work.”