A new survey from Undue Medical Debt offers a look at how medical debt accumulates, even among the insured, and what it does to consumers before their accounts are resolved.
The nonprofit, which has cancelled more than $40 billion in medical debt for over 27 million people, surveyed 153 recipients of its 2025 debt relief between January and April 2026. The findings are self-reported and not nationally representative, but they offer a rare window into the experiences of consumers whose accounts flow through the collections ecosystem.
The big picture: Insurance is not preventing medical debt. Among respondents, 82% were insured at the time of the survey, and more than half of Undue’s total 2025 debt relief went to people who had coverage when their debt was incurred. Nearly one in three respondents said their biggest healthcare cost challenge in the past year was a bill they expected insurance to cover, and another 21% pointed to bills owed before meeting their deductible. A clear majority, 63%, placed primary blame for their debt on insurance companies.
The survey’s findings on hospital financial assistance may be the most actionable. Six in ten respondents did not know that nonprofit hospitals are required to offer financial assistance. Among those who did not apply before their debt was erased, 76% said they simply did not know assistance existed. Of the 25% who did apply, 79% were denied, with respondents citing income thresholds, uncovered services and, in some cases, the fact that they had insurance at all.
The gap matters because patients who might have qualified for charity care instead took on debt: 22% used provider payment plans, 22% borrowed from family or friends, 20% turned to credit cards and 8% used payday loans. Nearly a quarter did not attempt payment at all.
The consumer impact figures deserve attention from the industry. Before their debt was erased, 76% of respondents said they were harassed by creditors or collection agencies, 63% saw their credit scores decline and 62% reported increased anxiety or depression. Half delayed or skipped doctor visits in the past year, and 48% experienced pain due to delayed care.
The survey also documents what relief looks like on the other side. After their debt was cancelled, 59% of respondents said their households could prioritize other spending, 66% said they were more likely to get routine medical care and 76% reported feeling less alone.
