# Health and Health Care Utilization Effects of Medical Debt Forgiveness

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2023 · $51,514

## Abstract

ABSTRACT
The U.S. health care system leaves many Americans struggling with medical debt. Approximately 44 million
individuals – both insured and uninsured – have medical debt in collections, and aggregate medical debt
outstanding is estimated at $75 billion. In surveys, patients report that medical debt leads them to delay or
reduce health care utilization. This reduction in utilization may produce immediate negative health effects as
well as longer-run negative health effects as individuals age. Medical debt may also have direct negative
impacts on mental health through the stress of debt and the debt collections process. Finally, medical debt
may compound the financial consequences of adverse health events by wiping out savings, ultimately
undermining a healthy and secure transition to retirement. Despite the widespread concern about medical
debt, there is little rigorous evidence examining the health consequences of medical debt and the potential
benefits of medical debt forgiveness. This proposal leverages an already-funded, recently-commenced
randomized control trial (RCT) on the effects of medical debt forgiveness on household finances. For this
already-funded, recently-commenced study, our non-profit partner RIP Medical Debt has agreed to purchase
and forgive debt for a randomly selected 12,000 individuals (for a total RCT sample size of 24,000 individuals,
including individuals in the control group). For this proposal, we are seeking funding to conduct a survey that
measures the health care utilization and health effects of medical debt forgiveness on our RCT sample.
Because debt abolishment is randomized, comparing surveyed outcomes of treatment and control subjects will
allow us to estimate the causal impact of medical debt abolishment. In particular, our survey will measure the
effects of medical debt on three sets of outcomes: (i) health care utilization, as measured by medical care
visits, prescription drug utilization and adherence, and unmet need for medical care; (ii) mental health, as
measured by validated screens for depression and anxiety; and (iii) subjective wellbeing, as measured by self-
reported health, subjective experience with medical debt, and forgone consumption. This study would be the
first to provide a direct, causal connection between the rising personal debt associated with U.S. health care
and the health outcomes of its recipients. And the study will seek to identify patient groups that are particularly
vulnerable to negative health impacts of medical debt, allowing health care providers and charities to target
debt relief so that the out-of-pocket costs for health care do not end up adversely affecting the health of
vulnerable patients.

## Key facts

- **NIH application ID:** 10616663
- **Project number:** 5R01AG066890-03
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** Wesley Yin
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $51,514
- **Award type:** 5
- **Project period:** 2021-04-15 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10616663

## Citation

> US National Institutes of Health, RePORTER application 10616663, Health and Health Care Utilization Effects of Medical Debt Forgiveness (5R01AG066890-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10616663. Licensed CC0.

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