Weighed down by rising costs, Americans are struggling to pay healthcare bills and are mired in medical debt, according to a recent study by the Commonwealth Fund.

In a survey of 7,873 Americans aged 19 and older, Commonwealth found that nearly three in four people without health insurance struggle to pay for their healthcare needs. But even those with insurance are swamped by rising costs, the nonprofit said.

Around six in 10 Americans with insurance through the Affordable Care Act marketplace say paying their medical bills is “very or somewhat difficult.”

Among other findings, 38% of respondents claim they skipped receiving medical treatment or refilling a prescription because they couldn’t afford it. Another 38% cut back on food, heat, or rent to pay for healthcare.

The culprit is the rising costs of healthcare and health insurance in the U.S. The study found one in three Americans owe medical debt; half of them say it’s $2,000 or more.

In 2021, Americans owed $88 billion in medical debt, according to the Consumer Financial Protection Bureau. Half of those who reported having medical debt said it was from getting treatment for an ongoing medical condition.

Local governments are working to relieve the medical debt burden

The medical debt burden is a problem policymakers are taking seriously.

In September, the White House proposed to remove medical debts from credit reports. That way, those suffering from expensive medical conditions that overwhelm their finances are not kept from renting or borrowing money they need to finance purchases.

But many local governments are also taking action this year to directly wipe out medical debt with loan forgiveness programs.

Michigan’s Oakland County, for example, is erasing $2 million in medical bills owed by 80,000 Detroit residents. Cook County approved a deal on Oct. 24 to wipe out $280 million in medical debt affecting 158,000 Chicago residents.

Meanwhile, Illinois charities have helped forgive $3 million in medical debts in 2023.

On Oct. 16, Ohio’s Columbus City Hall approved a deal to forgive $335 million in medical debt for 340,000 residents. Los Angeles County has a similar program under consideration to erase $2.6 billion owed by residents for medical loans.

More than a dozen states this year are also taking action in a patchwork effort to relieve mounting medical debt to pay hospital, doctor, and other medical provider bills

Medical and health insurance costs have ballooned for years

Inflation hasn’t left the hospital, medical provider, and health insurance industries untouched.

Annual spending on prescription drugs in the U.S. grew from $520 billion in 2016 to $603 billion in 2021, a 16% increase. Retail prescription drugs accounted for $421 billion of the total, almost 70%.

Hospital expenses have also risen. ICU medical supplies, for example, increased 31.5% in 2021 over a 2019 baseline. Medical supplies account for 20% of hospital costs on average.

Overall healthcare spending grew 10.3% during the pandemic in 2020, but even as the pandemic slowed, U.S. health spending grew by 2.7% in 2021 to a whopping $4.3 trillion.