100 Million Americans Carry Medical Debt (2026)
Healthcare inflation running at 2.0%, running 1.4 percentage points below overall CPI. Medicaid enrollment down 17.2M from its pandemic peak. Four indicators tracking the cost of staying healthy in America, from BLS, CMS, and the CFPB.
How Fast Are Healthcare Costs Rising?
The Medical Care CPI reads 2.0% year-over-year as of 2026-06 — below the 2019 pre-pandemic average of 2.8%, but well off the 6.0% peak hit in 2022 09 during the post-COVID surge. Unlike grocery prices or energy, there is no substitution strategy. You cannot switch to a cheaper appendectomy.
The premium over overall inflation tells the cycle story. Healthcare CPI currently runs −1.4pp versus overall CPI (running 1.4 percentage points below overall CPI). The 5-year average (2019-2023) was −1.4pp; the historical peak was +5.2pp in 2009 07. The current negative premium reflects a relative cooling in medical-care prices alongside reaccelerating energy costs in the broader CPI basket — a temporary inversion of the long-run pattern. Households still face elevated absolute healthcare costs (CPI is +2.0% YoY); the gap above headline has flipped sign in this cycle. The cost-of-living statistics page tracks healthcare alongside other expense categories. For downstream effects on household finances, see household financial health statistics. The American Distress Index measures the distress that follows — missed payments, depleted savings, rising debt loads — currently reading 43.8 (Typical). On average, its inputs sit higher than in 44% of their own quarterly histories.
Key Statistics at a Glance
Healthcare spending is the second-largest household expense category after housing. When medical costs outpace wages, the difference gets absorbed by savings, debt, or foregone care — pressure that shows up in the ADI's Safety Net & Buffer and Debt Burden domains. The American Distress Index currently reads 43.8 (Typical). On average, its inputs sit higher than in 44% of their own quarterly histories. The Medicaid unwinding removes the insurance safety net for millions, changing who may face out-of-pocket medical costs. Enrollment, collections, and bankruptcy filing data describe separate populations and do not establish one household's path from one measure to another.
How Fast Are Healthcare Costs Rising vs. Overall Inflation?
The Medical Care CPI (series CUSR0000SAM) measures year-over-year price change across hospital services, physician fees, prescription drugs, and health insurance. As of 2026-06, it reads 2.0% — below the 2019 average of 2.8% and well off the 6.0% peak in 2022 09.
As of 2026-06, healthcare CPI is running 1.4 percentage points below overall CPI. The premium has temporarily flipped negative; the longer-run pattern is still upward, but the current quarter sits inside an inversion. Over the last two decades, healthcare inflation has outpaced overall CPI in 68% of months (BLS, computed across the trailing 20-year window) — a structural upward bias driven by Baumol-cost-disease dynamics, demographic demand, and limited substitution. Reversals occur during deflationary shocks (2008-2009) or when overall inflation surges (the post-2022 cycle is the second of those). For workers whose wages track overall CPI, each year of excess healthcare inflation erodes purchasing power. For retirees on fixed incomes, the effect is compounding.
Medical Care CPI vs. Overall CPI (Year-over-Year, %)
Source: Bureau of Labor Statistics, Consumer Price Index — Medical Care (CUSR0000SAM) and All Items (computed from premium). Monthly, not seasonally adjusted.
Full data and trend: Medical Care CPI indicator page
How Does the Healthcare Premium Move Through the Cycle?
The healthcare inflation premium measures the gap between Medical Care CPI and overall CPI. A positive value means healthcare costs are rising faster than the general price level. As of 2026-06, the premium reads −1.4pp. The five-year average (2019-2023) was -1.4 points — lower than the long-run norm because the 2021-2022 inflation surge pushed overall CPI above healthcare inflation, and the gap has not yet flipped back.
The premium peaked at 5.2 points in 2009 07, during the Great Recession. That's the pattern worth watching. Overall prices were falling. Healthcare costs continued rising. Income shrank while the one expense category that cannot be deferred kept climbing. The premium has spent extended stretches at or below zero in past cycles too — the long-run direction is upward, not the quarter-by-quarter sign. Healthcare doesn't care what the rest of the economy is doing.
Healthcare Inflation Premium (Medical CPI minus Overall CPI, pp)
Source: Bureau of Labor Statistics (computed: CUSR0000SAM minus CUUR0000SA0). Monthly, not seasonally adjusted.
Full data and trend: Healthcare inflation premium indicator page
Are Prescription Drug Prices Coming Down?
Prescription Drug CPI (series CUSR0000SEMF01) reads -2.5% year-over-year as of 2026-06. The negative reading marks a structural shift. For most of 2001-2016, prescription drug prices rose 3-7% annually, peaking at 7.1% in 2016 10. The trend broke in 2017 amid public pressure and pharmacy benefit manager negotiations. By 2019, the average was -0.2%, essentially flat.
The Inflation Reduction Act (2022) introduced Medicare drug price negotiation for the first time, starting with 10 high-cost drugs in 2026. Early market signals suggest pharmaceutical companies are adjusting pricing strategies in anticipation. But prescription drugs are only a fraction of total healthcare spending. Hospital services, physician fees, and insurance premiums — which are not subject to the same negotiation framework — continue to rise. Falling rx prices provide partial relief to households with chronic conditions, but do not offset the broader medical cost burden tracked by the Medical Care CPI.
Prescription Drug CPI Year-over-Year Change (Monthly, %)
Source: Bureau of Labor Statistics, Consumer Price Index — Prescription Drugs (CUSR0000SEMF01, monthly, not seasonally adjusted).
Full data and trend: Prescription Drug CPI indicator page
How Many People Lost Medicaid Coverage?
Medicaid and CHIP enrollment peaked at 94.0M in early 2023, after the Families First Coronavirus Response Act prohibited states from disenrolling beneficiaries during the public health emergency. When continuous enrollment ended in April 2023, states began redeterminations. Enrollment has since fallen to 76.8M as of 2025-09 — a decline of 17.2M.
Here's what makes the Medicaid numbers particularly unsettling. Not all disenrollees found alternative coverage. KFF surveys estimate that a significant share became uninsured, particularly among adults in states that did not expand Medicaid under the ACA. Many others lost coverage for procedural reasons — returned mail, missed renewal forms, state processing backlogs — rather than because they were actually ineligible. The paperwork expired. The coverage didn't have to. For households already in financial hardship, losing Medicaid coverage can be the trigger that converts a manageable situation into a medical debt crisis.
Medicaid/CHIP Enrollment (Millions)
Source: Centers for Medicare & Medicaid Services (CMS), Medicaid & CHIP Monthly Enrollment.
Full data and trend: Medicaid/CHIP enrollment indicator page
What Do the Medical-Debt Measures Show?
The Consumer Financial Protection Bureau found that 58% of debt in third-party collections was medical debt in its national study. The measure establishes the composition of collection tradelines in that dataset. It does not identify the circumstances that produced each bill or a later legal outcome for the affected household.
Healthcare CPI, Medicaid enrollment, medical debt in collections, and bankruptcy filings come from different sources and populations. Reading them together can describe concurrent conditions, but the aggregate data on this page cannot show that one measure caused movement in another.
Four Measures, Four Evidence Boundaries
Healthcare CPI measures price change. Medicaid enrollment counts people enrolled in public coverage. CFPB research describes medical debt reported in collections. The Administrative Office of the U.S. Courts counts bankruptcy cases filed. Each answers a different question.
No record-level linkage in these sources establishes a sequence from a price change or coverage change to collections and then to a court filing. The ADI therefore uses the measures as separate inputs and does not convert their co-movement into a household-level causal claim.
Explore the separate bankruptcy filing series →Data Sources and Methodology
BLS Consumer Price Index — Medical Care
Series CUSR0000SAM. Covers hospital and related services, physician services, prescription drugs, and health insurance. The broadest measure of healthcare cost inflation for consumers. Monthly, not seasonally adjusted.
BLS Consumer Price Index — Prescription Drugs
Series CUSR0000SEMF01. Tracks year-over-year price change for prescription medications. A subset of Medical Care CPI, isolated to show the drug pricing trend separately from services. Monthly, not seasonally adjusted.
Centers for Medicare & Medicaid Services
Monthly Medicaid and CHIP enrollment data from CMS enrollment reports. Covers all 50 states plus DC and territories. Used to track the pandemic continuous enrollment period and subsequent unwinding. Updated with a 3-6 month lag.
CFPB Medical Debt Research
Consumer Financial Protection Bureau research on medical debt in collections and credit reporting. Bankruptcy filing totals on this page come separately from the Administrative Office of the U.S. Courts.
Frequently Asked Questions
How much have healthcare costs gone up in 2026?
The BLS Medical Care CPI reads 2.0% year-over-year as of 2026-06. That is below the 2019 average of 2.8% and well above the near-zero readings of late 2023. Healthcare costs peaked at 6.0% in 2022 09 during the post-pandemic inflation surge but remain structurally elevated above overall inflation. The full time series is tracked in the Medical Care CPI indicator.
Is healthcare inflation higher than overall inflation?
Not currently. The healthcare inflation premium — Medical Care CPI minus overall CPI — reads −1.4pp as of 2026-06. Healthcare CPI is currently running 1.4 percentage points below overall CPI — a continuation of the inversion that began with the 2022 inflation surge. The 2019-2023 windowed average was −1.4pp (the 2022 spike pulled the window negative; the all-time series mean is positive). The current negative reading reflects a relative cooling in medical-care prices alongside reaccelerating energy and shelter costs in the broader CPI basket. Households still face elevated absolute healthcare costs (CPI is +2.0% YoY), but the gap above headline has temporarily flipped. See the healthcare inflation premium indicator for the full history.
Are prescription drug prices going down?
The Prescription Drug CPI reads -2.5% year-over-year as of 2026-06 (BLS, series CUSR0000SEMF01). The decline follows years of moderation: the 2019 average was -0.2%, already near zero after peaking at 7.1% in 2016 10. The series has dipped negative occasionally over the past two decades. But rx prices are just one component of healthcare spending. Out-of-pocket costs, insurance premiums, and service prices (hospital stays, specialist visits) continue rising and are not captured in this measure. The full series is at Prescription Drug CPI.
How many people lost Medicaid coverage in the unwinding?
Approximately 17.2M people have lost Medicaid or CHIP coverage since the pandemic-era continuous enrollment requirement ended in April 2023. Enrollment peaked at 94.0M and has fallen to 76.8M as of 2025-09. Many of those disenrolled are still eligible but lost coverage due to administrative barriers — returned mail, missed redetermination deadlines, paperwork processing errors. The Congressional Budget Office estimated that a significant share of disenrollees transitioned to uninsured status rather than employer or marketplace coverage.
How are medical debt and bankruptcy data related?
The Consumer Financial Protection Bureau found that 58% of debt in third-party collections was medical debt in its national medical-debt study. Bankruptcy statistics come from a separate Administrative Office of the U.S. Courts filing table. Neither dataset links a particular medical bill to a later bankruptcy case, so this page reports the measures separately rather than treating them as a causal sequence.
How do healthcare costs connect to the American Distress Index?
Healthcare costs are context for the ADI rather than a direct input. When healthcare costs rise faster than wages, the excess comes from household savings, food budgets, or debt — and the savings rate that absorbs the pressure is the input to the ADI's Safety Net & Buffer domain. The ADI currently reads 43.8 (Typical). On average, its inputs sit higher than in 44% of their own quarterly histories. The Medicaid unwinding adds to distress by removing the insurance safety net for millions, increasing out-of-pocket exposure. For the full index methodology, see the ADI page. The cost-of-living statistics page tracks healthcare alongside other expense categories.