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Tens of millions of Americans are making painful sacrifices due to health care debt

MARY LOUISE KELLY, HOST:

Health care debt in the U.S. is now so big, it has hit more than half of all adults. That's according to a new investigation by Kaiser Health News and NPR. The investigation also looked at the toll this debt takes, how it forces tens of millions of people to make painful sacrifices to deal with their medical and dental bills. Joining me now, Noam Levey with Kaiser Health News. Hey there.

NOAM LEVEY: Hi.

KELLY: All right. So give me more of a sense just of the scale of this debt. I said it is so big. How big are we talking?

LEVEY: Well, really, really big. Altogether, about 100 million people in this country currently have some kind of health care debt. That's from a nationwide poll we did with our team at KFF, the Kaiser Family Foundation. So this isn't just people with medical bills in collections. It's people using credit cards, payment plans and other loans to pay for health care. So it's a lot of debt. Now, you know, I think it's important to know the problem would be a lot worse without the Affordable Care Act, which provided millions of people with insurance. But the law didn't slow the growth of high deductible health plans, which have really helped fuel this debt crisis.

KELLY: Yeah. And what does that look like just on an individual level? Tell me a story.

LEVEY: I mean, it's heartbreaking. I can't tell you, Mary Louise, how much suffering there is out there. I've talked to people who have lost their homes, who've had to cut back on food, drain retirement accounts, put off their education plans. One family that really stuck with me are the Bucks. Ariane and Samantha Buck live just outside Phoenix. They have three kids. They work but don't have a lot of money. And they've had their share of medical challenges, several trips to the E.R. over the years - her for ovarian cysts and him for an intestinal infection. One of their kids is autistic. And they say it's all added up to about $50,000 in debt. And that's led to a lot of scrimping. Ariane says that's been really hard on the kids.

ARIANE BUCK: They want to go to the mall. They want to go to, just on trips to, like, Sedona or Flagstaff and day trips. But even that little bit of extra money is just too much. We just don't have it.

LEVEY: And if they go out, it's usually just for fast food. Ariane said they sometimes go without school supplies. They rely on family for Christmas gifts.

BUCK: Makes you feel like a failure, like I'm not giving my kids the best life possible. I mean, the best I can do for them is just put a roof over their head.

KELLY: Wow, that's hard. How many people have you spoken to who are facing choices like the Bucks?

LEVEY: Well, our poll found that more than half of Americans with health care debt said they have had to make a difficult sacrifice. And we're not just talking about low-income Americans here. I talked to a mother in Chicago, solidly middle class. She's a nurse, had to take on double shifts after her twins were born prematurely to pay down $80,000 in debt. You know, even small debts can cause problems. I talked to a medical student in Texas who was harassed by debt collectors for years over a $131 bill, which was for an exam she got after being sexually assaulted.

KELLY: Oh, gosh. Yeah. OK.

LEVEY: Yeah, it's bad. And, you know, another perverse impact of this debt is that it's actually blocking patients from getting care. We found about 1 in 7 say they've been turned away from a doctor or hospital or other provider because they owe money. This happened to Ariane Buck, too. He came down with a really bad stomach bug a few years ago.

BUCK: I wasn't able to keep anything down. I wasn't able to use the bathroom properly. And I tried to call my own doctor that I had at the time to go see him. However, when I called to make the appointment, I was denied due to me owing them less than $100, actually.

LEVEY: He ended up having to go to the emergency room and thankfully recovered, but the visit meant thousands of dollars in bills. And, you know, the whole experience left the Bucks feeling pretty disillusioned.

BUCK: I see other countries, and I see what their health insurance is. And it's, like, they don't have as much of an issue when it comes to that. And it's just like, that's just not right. Everyone should at least be able to get to a doctor when they feel ill.

LEVEY: And, sadly, that's a sentiment I heard again and again across this country.

KELLY: OK. Thanks for your reporting.

LEVEY: Thank you.

KELLY: That is Noam Levey. And NPR's ongoing investigation into medical debt is in partnership with Kaiser Health News. Transcript provided by NPR, Copyright NPR.