Kaiser Family Foundation: ” With one in three Americans reporting that they have difficulty paying their medical bills, this report looks at some of the reasons Americans encounter medical debt, even when they have insurance, by drawing insights from the experiences of nearly two dozen people who recently experienced such problems. This report identifies common causes and consequences of medical debt, and discusses the triggers of medical debt that will and will not be affected by the Affordable Care Act. It finds that health plan cost-sharing is a primary contributor to medical debt.  Even relatively modest cost sharing can prove unaffordable because expenses often are unexpected and most Americans have less than $3,000 on hand to cover such costs. For many, unaffordable cost-sharing may be compounded by other factors:

• Out-of-network expenses may also arise, often inadvertently for people who are hospitalized when hospital-based providers aren’t in the plan network
• Health care providers tend to promptly refer patients who can’t pay to collections
• Patients may use credit cards to pay unaffordable medical bills, which increases debt
• Illness often triggers income loss, further aggravating affordability problems
• People facing health issues may have trouble tracking medical expenses and resolving billing problems on their own.
• Medical debt is also linked to housing instability, reduced retirement savings, damaged credit, bankruptcy and barriers to accessing care.”