By Joseph Q. Jarvis | Published: 16 September 2026
In 2022 the Kaiser Family Foundation (KFF) published its Health Care Debt Survey in partnership with National Public Radio. They found that 100 million people in the United States carry medical debt. A quarter of US adults have health care debt in excess of $5000 and 20% have an amount of medical debt which they don’t ever expect to pay off. This burden of debt is forcing families to cut spending on food and other essentials and is driving millions from their homes or into bankruptcy. This debt is piling up despite the so-called Affordable Care Act, which perversely financially embarrassed patients while enriching health care corporations. That finding is due to the fact that the Affordable Care Act created a health insurance industry push to increase out of pocket costs for patients in the form of co-payments, deductibles, or co-insurance while half of US adults don’t have cash reserves to cover an unexpected $500 health care bill. The irony is that more Americans have health insurance but fewer Americans can actually afford health care. Profits are up for hospitals, pharmaceutical firms, and insurers since the Affordable Care Act passed, but so is medical debt. The result, many Americans are functionally uninsured, meaning they have health insurance but can’t get the insurance company to make any payments for needed health care.
In a more recent KFF poll, dating to April 2026, just under 1/2 of US adults say it is difficult to afford health care costs and about three in ten say they or a family member had problems paying for health care in the past year. About one in three American adults have skipped or postponed getting needed health care because of cost. For those under 65 (i.e., not Medicare eligible) 75% of uninsured adults went without needed care because of cost. American patients are not taking medication as prescribed because they can not afford to fill the prescription. Four in ten insured adults in the US worry about affording their health insurance costs.
No wonder that THIS YEAR American voters’ top economic worry is the cost of health care. Six in ten US adults say they are very or somewhat worried about affording health care costs for themselves and their families.
For more information about KFF and its polling about health policy please see:
KFF Health Tracking Poll: Public Views on Fraud in Government Health Programs | KFF
These data do not surprise me. I have been advocating for real and sustainable change in how we Americans do health care business for more than 30 years. I have published two books about health system reform:
The Purple World: Healing the Harm in American Health Care
Find it here: The Purple World: Healing the Harm in American Health Care
For the Hurt of My People: Original Conservatism and Better Simpler Health Care
Find it here: For the Hurt of My People: Original Conservatism and Better, Simpler Healthcare
I have also produced a documentary film about the fiasco of American health care which is entitled
Healing US
Watch it here: YouTube video
More recently, along with others, I have drafted a health care reform statute which, if implemented, would guarantee better, simpler health care financed fairly for all. It is written for the state of Utah, and is called the Utah Cares Act, but could be implemented in any state. There are dozens of other states where people like me have drafted similar bills. If you would like to read the Utah Cares Act, you can find it and the economic studies which support it at View source at utahcares.health
Please be aware that the Utah Cares website has been falsely labeled by some cybersecurity services as risky. There is not now nor ever has been malware or any similar problem on the Utah Cares website. Technical staff are currently working hard to get the various cybersecurity services to properly label our website.
If you would like to contribute to the campaign to improve American health care you can donate on the Utah Cares website, or send a check made out to: Utah Cares PIC. 1373 Perrys Hollow Drive, SLC UT 84103
As of today, only in the USA among developed nations do patients go without needed health care because they can not afford it. And only in the USA are hundreds of thousands of citizens bankrupted by the cost of health care every year. During the mid-term election season, you can do something about these tragedies. You can grow the campaign to change how we Americans do health care business. Donate to this cause. Help Utah Cares put this on the ballot in Utah and in every other state.
Dr. Joseph Q. Jarvis is a public health physician, chair of the Utah Cares Political Issue Committee and author of several books, including The Purple World: Healing the Harm in American Health Care and What the Single Eye Sees: Faith, Hope, Charity, and the Pursuit of Discipleship.