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The credit consequences of unpaid medical bills

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  • Brevoort, Kenneth
  • Grodzicki, Daniel
  • Hackmann, Martin B.

Abstract

This paper quantifies the costs of leaving medical bills unpaid and what these costs imply for the value of health insurance to beneficiaries. We argue that a large fraction of unpaid medical bills is sent to third-party collections and reported to credit bureaus, with detrimental effects on patients' credit outcomes. Combining a large panel of credit records with data on credit offers, we find that the ACA Medicaid expansion reduced newly-reported medical collections by $5.89 billion and led to better terms of credit. We find that the financial benefits of Medicaid at least double when including this indirect credit channel.

Suggested Citation

  • Brevoort, Kenneth & Grodzicki, Daniel & Hackmann, Martin B., 2020. "The credit consequences of unpaid medical bills," Journal of Public Economics, Elsevier, vol. 187(C).
    • Handle: RePEc:eee:pubeco:v:187:y:2020:i:c:s0047272720300670
    DOI: 10.1016/j.jpubeco.2020.104203
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    16. Gallagher, Emily A. & Gopalan, Radhakrishnan & Grinstein-Weiss, Michal, 2019. "The effect of health insurance on home payment delinquency: Evidence from ACA Marketplace subsidies," Journal of Public Economics, Elsevier, vol. 172(C), pages 67-83.
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    Cited by:

    1. Sarah Miller & Luojia Hu & Robert Kaestner & Bhashkar Mazumder & Ashley Wong, 2021. "The ACA Medicaid Expansion in Michigan and Financial Health," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(2), pages 348-375, March.
    2. Yaa Akosa Antwi & Marion Aouad & Nathan Blascak, 2023. "I've Got 99 Problems But a Bill Ain't One: Hospital Billing Caps and Financial Distress in California," Working Papers 23-20, Federal Reserve Bank of Philadelphia.
    3. Cortnie Shupe, 2023. "Public Health Insurance and Medical Spending: The Incidence of the ACA Medicaid Expansion," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 42(1), pages 137-165, January.
    4. Marguerite Burns & Laura Dague, 2023. "In-Kind Welfare Benefits and Reincarceration Risk: Evidence from Medicaid," NBER Working Papers 31394, National Bureau of Economic Research, Inc.
    5. Michael Batty & Christa Gibbs & Benedic Ippolito, 2022. "Health insurance, medical debt, and financial well‐being," Health Economics, John Wiley & Sons, Ltd., vol. 31(5), pages 689-728, May.
    6. Gallagher, Emily A. & Gopalan, Radhakrishnan & Grinstein-Weiss, Michal, 2019. "The effect of health insurance on home payment delinquency: Evidence from ACA Marketplace subsidies," Journal of Public Economics, Elsevier, vol. 172(C), pages 67-83.
    7. Nathan Blascak & Vyacheslav Mikhed, 2023. "Health Insurance and Young Adult Financial Distress," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 42(2), pages 393-423, March.
    8. Drake, Coleman & Anderson, David & Cai, Sih-Ting & Sacks, Daniel W., 2023. "Financial transaction costs reduce benefit take-up evidence from zero-premium health insurance plans in Colorado," Journal of Health Economics, Elsevier, vol. 89(C).
    9. Owen (O.A.) O'Donnell, 2019. "Financial Protection Against Medical Expense," Tinbergen Institute Discussion Papers 19-010/V, Tinbergen Institute.
    10. Samuel Dodini, 2023. "Insurance Subsidies, the Affordable Care Act, and Financial Stability," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 42(1), pages 97-136, January.
    11. Seonghoon Kim & Kanghyock Koh, 2022. "Health insurance and subjective well‐being: Evidence from two healthcare reforms in the United States," Health Economics, John Wiley & Sons, Ltd., vol. 31(1), pages 233-249, January.
    12. Billings, Stephen B. & Gallagher, Emily A. & Ricketts, Lowell, 2022. "Let the rich be flooded: The distribution of financial aid and distress after hurricane harvey," Journal of Financial Economics, Elsevier, vol. 146(2), pages 797-819.

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    More about this item

    Keywords

    Unpaid medical bills; Credit consequences; Value of Medicaid;
    All these keywords.

    JEL classification:

    • D14 - Microeconomics - - Household Behavior - - - Household Saving; Personal Finance
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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