U.S. Senators Dan Sullivan (R-Alaska) and Ashley Moody (R-Florida) are urging the U.S. Department of Health and Human Services to uncover improper health care billing practices that lead to high levels of medical debt. Instances of high medical debt continue to be a top concern for Americans, and there are reports that indicate hospital bills charged to uninsured patients that end up as medical debt are often well in excess of the actual cost of providing the service.
“We are writing to request you investigate and provide recommendations to Congress for addressing inappropriate health care billing practices that lead to high levels of medical debt,” said the Senators. “Despite efforts by Congress and the Administration to insulate patients from ‘surprise’ medical bills in the No Surprises Act, after four years of runaway inflation and increasing health costs under the Biden administration, instances of high medical debt continue to be a top concern for our constituents.”
While most medical debt sent to collections is under $300, approximately 14 million Americans owe over $1,000. Three million have incurred medical debt that exceeds $10,000, representing almost 80 percent of the aggregate medical debt owed in the United States.
High hospital bills have been a key factor for those suffering from high levels of medical debt. Almost 70 percent of Americans with medical debt under $1,000 reported having no hospital bills at all, but over 70 percent of those with debt over $1,000 reporting owing debt to hospitals, according to a 2022 survey.
Just last month, an investigation found “facilities on average charge the uninsured almost five times what Medicare pays for the same procedure.” Senators Sullivan and Moody are directing HHS to investigate root causes of instances of inordinately high medical debt and provide recommendations to Congress.
Press release provided by Arianna Erkmann, Press Assistant at the Office of U.S. Senator Dan Sullivan.
Full Letter
Dear Secretary Kennedy:
We are writing to request you investigate and provide recommendations to Congress for addressing inappropriate health care billing practices that lead to high levels of medical debt.
Despite efforts by Congress and President Trump to insulate patients from “surprise” medical bills in the No Surprises Act1, after four years of runaway inflation and increasing health costs under the Biden Administration, instances of high medical debt continue to be a top concern for our constituents.
While most medical debt sent to collections is under $3002, approximately 14 million Americans owe over $1,000. Three million have incurred medical debt that exceeds $10,000, representing almost 80 percent of the aggregate medical debt owed in the United States.3 High hospital bills have been a key factor for those suffering from high levels of medical debt. Almost 70 percent of Americans with medical debt under $1,000 reported having no hospital bills at all, but over 70 percent of those with debt over $1,000 reporting owing debt to hospitals, according to a 2022 survey.4
Perhaps most disturbing, there are many reports that indicate hospital bills charged to the uninsured that end up as medical debt are often well in excess of the actual cost of providing the service. Just last month, an investigation by NBC News found “facilities on average charge the uninsured almost five times what Medicare pays for the same procedure.”5 Additionally, while cash rates for health care services are lower than the official hospital list prices, actually securing these lower rates requires navigating a complex bureaucracy that patients rarely can access without specialized advocacy they do not know exists. Instead, hospitals routinely send vulnerable, uninsured patients to collections using inflated sticker prices, which creates an unfair system penalizing the poorest patients, and disregards the community benefit mandate hospitals are required to uphold.
In your investigation, which should include Alaska and Florida, we encourage you to investigate root causes of instances of inordinately high medical debt. Recent academic work on initiatives to address symptoms, such as the largest study of medical debt relief programs involving over 83,000 individuals, found “no evidence that buying and then forgiving medical debts that are in collections improved on average beneficiaries’ finances, access to credit, or their physical or mental health.”6 Similarly, efforts by the last Administration to focus on the impact of medical debt on credit scores have been criticized as likely to lead to higher borrowing costs for all consumers, reduce the likelihood of medical providers to treat those perceived to be at high-risk of non-payment, and increase pre-payment requirements from medical providers.7
Thank you for your attention to this important matter, and we look forward to working with you further on this and other efforts to address root causes increasing health care costs.
Sincerely,
Dan Sullivan
United States Senator
Ashley Moody
United States Senator
High-Medical-Debt-letter-Sullivan-and-Moody.pdf
- Division BB, Title I of the Consolidated Appropriations Act, Public Law 116-26 ↩︎
- Ben Ippolito, Medical Debt in the United States, Statement before the Senate Committee on Banking, Housing, and
Urban Affairs, March 29, 2022, https://www.banking.senate.gov/imo/media/doc/Ippolito%20Testimony%203-29
22.pdf ↩︎ - Sharmeek Rakshit, Matthew Rae, Gary Claxton, Krutika Amin, and Cynthia Cox, The burden of medical debt in
the United States, Peterson-Kff Health System Tracker, February 12, 2024,
https://www.healthsystemtracker.org/brief/the-burden-of-medical-debt-in-the-united
states/#Share%20of%20adults%20who%20have%20medical%20debt,%20by%20household%20income%20and%2
0insurance%20status,%202021 ↩︎ - Michael Karpman, Most Adults with Past-Due Medical Debt Owe Money to Hospitals, Urban Institute, March 13,
2023, https://www.urban.org/sites/default/files/2023-03/Most%20Adults%20with%20Past
Due%20Medical%20Debt%20Owe%20Money%20to%20Hospitals_0.pdf ↩︎ - Gretchen Morgenson, Hospital costs are rising far faster than inflation and drowning Americans in debt, NBC
News, April 2, 2026, https://www.nbcnews.com/investigations/hospital-costs-are-rising-far-faster-inflation
drowning-americans-debt-rcna262473 ↩︎ - 6Krysten Crawford, Study finds medical debt relief doesn’t always work, Stanford Institute for Economic Policy
Research, April 8, 2024, https://siepr.stanford.edu/news/study-finds-medical-debt-relief-doesnt-always
work#:~:text=Mahoney%20and%20his%20collaborators%20find,after%20their%20debt%20was%20eliminated. ↩︎ - Ben Ippolito, Medical Debt in the United States, Statement before the Senate Committee on Banking, Housing, and
Urban Affairs, March 29, 2022, https://www.banking.senate.gov/imo/media/doc/Ippolito%20Testimony%203-29
22.pdf ↩︎
