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Even among Americans with insurance, those with chronic illnesses are significantly more likely to experience financial troubles than healthier individuals. Moreover, as the number of chronic illnesses a person has increases, so does the debt they likely carry, according to a new study in JAMA Internal Medicine.
“Simply put, commercially insured people with chronic conditions are at very higher risk of financial distress,” study coauthor Nora Becker, M.D., a health economist at the Institute for Healthcare Policy & Innovation at the University of Michigan, said in a statement.
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The cross-sectional study included more than 2.8 million adults (age 21 and older) enrolled in a commercial preferred provider organization in Michigan. Using insurance claims and credit report data, the researchers analyzed the financial stress for individuals based on 13 chronic conditions: cancer, congestive heart failure, chronic kidney disease, dementia, depression and anxiety, diabetes, hypertension, ischemic heart disease, liver disease, chronic obstructive pulmonary disease and asthma, serious mental illness, stroke, and substance use disorders.
Study findings
The analysis showed increasing rates of medical debt in collections, non-medical debt in collections, total delinquent debt, low credit score and recent bankruptcy as an individual’s number of chronic conditions increased.
For example, individuals with seven to 13 chronic conditions had a 32 percent chance of having medical debt in collections, compared to just 7.6 percent among individuals with no chronic conditions. Among the adults who had medical debt in collections, the total amount was likely to be $1,252 for those with seven to 13 chronic conditions, compared with $784 for those without chronic conditions, according to the researchers.
Other predicted probabilities for those with seven to 13 chronic conditions were:
- Non-medical debt collections — 24 percent, compared with 7.2 percent for no conditions
- Delinquent debt — 43 percent, compared with 14 percent for no conditions
- Low credit score — 47 percent, compared with 17 percent for no conditions
- Recent bankruptcy — 1.7 percent, compared with 0.4 percent for no conditions