EDITOR’S NOTE: If you are experiencing thoughts of suicide or concerned someone you know may be, the National Suicide Prevention Lifeline can be reached at 800-273-8255 and online chat is also available.

In 2019, when Aubrey Raelynn Snyder of Kansas City, Missouri, was 26 years old, she began experiencing symptoms of a severe illness: frequent nosebleeds, migraines, sudden blackouts, and nausea. As her symptoms progressively worsened, she took a medical leave from her job to prepare for a possible craniotomy to remove tumors that had formed on the inside of her skull and around her left ear.

She was diagnosed with atypical trigeminal neuralgia, a rare but excruciatingly painful chronic nerve condition that is also referred to as the “Suicide Disease.” After several surgeries to remove the tumors and try to alleviate her pain, Snyder still remains in agony. 

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She eventually lost her job, and the medical insurance that came with it. Now she is saddled with around $20,000 in medical debt, and still trying to fight with her previous health insurance company and medical billing offices to resolve outstanding bills from past surgeries, doctor visits, and prescription medications—not even including the thousands of dollars she has spent out of pocket on insurance premiums, deductibles, and copays. 

“I’m struggling right now,” said Snyder. “I owe a little under $4,000 to my pain management doctor and they are actually trying to terminate me from their practice because of this issue.” 

Now 29 years old, Snyder relies on Social Security disability benefits, which amount to less than $1,000 a month. She is behind on rent and still trying to obtain rental assistance. She’s now covered by Medicaid but is still struggling to maintain her ability to see her current doctors, to whom she still owes payment for outstanding medical bills. Meanwhile, she continues to suffer from pain so debilitating she sometimes has trouble getting out of bed or completing menial daily tasks.

“I would say 90% of the time over the last three years, I’ve thought about suicide every day, and then there’s been two failed attempts in the last three years of committing suicide,” added Snyder. “It’s just hard to look for a better life when it’s just been so difficult.” 

Around 23 million Americans, roughly 9% of the US adult population, owe more than $250 in medical costs, with about half of those owing over $2,000, according to an analysis of 2020 government data. 

Americans owed an estimated $195 billion total in medical debt as of 2019. 

Medical costs are the largest contributor to personal debt in the US, surpassing all other debt in collections combined, and hitting individuals in states that have declined to expand Medicaid, people in low-income communities, and Black Americans the hardest.

Medical costs are a leading contributor to more than half of all bankruptcies filed by individuals. And many Americans are constantly faced with recurring medical bills that have either already been paid, forgiven, or erroneously charged.

Millions of Americans report delaying or avoiding medical care every year because of the high costs and debt risks associated with obtaining medical treatment. Nearly 1 in 2 adults in the US report worrying about how to pay medical costs if they get sick or are involved in an accident, and thousands of Americans die every year because they can’t afford medical care. Other wealthy countries spend on average about half as much per person on healthcare than the US, despite providing universal health care coverage, while millions in the US remain uninsured or underinsured annually. 

58-year-old Anna Pearson Walsh of New Hampshire was diagnosed with lung cancer about one year ago, right before she was scheduled for spinal fusion surgery. She is covered under her husband’s health insurance plan, but that includes a $1,000 deductible every year, on top of insurance premiums and copays.

Her medical bills quickly piled up to the point that she currently owes around $6,000, but is on a payment plan to keep the debt out of collections. Due to her diagnosis, however, she still needs constant medical screening, and her overall debt continues to rise. 

“It’s stressful. Every time I have to add to the bills, my payment goes up. Now I have to pay $250 a month, and I’m still going to need scans until I die. There’s no cure, so the bills just go up and up and up. It’s maddening,” said Pearson Walsh. “Every time I see the doctor, the oncologist, there’s a copay, and it just adds up a lot. I try not to think about it because it adds a lot of stress.”

Credit agencies Experian, Equifax, and TransUnion recently announced changes to how medical debt is included on credit reports, with plans to remove paid-off medical debt from reports immediately and to offer consumers up to one year to work with insurance or healthcare providers to pay off medical debt before said debt shows up on their credit reports. Moreover, medical debts under $500 won’t be included on credit reports. 

These changes are set to begin this summer, but the Consumer Financial Protection Bureau (CFPB) issued a report on March 1 arguing that the COVID-19 pandemic has likely worsened the issue in the US and that medical debt has severe adverse effects on Americans’ financial, mental, and physical health. The report notes about half of all people impacted by COVID-19, whether through an infection, job loss, or loss of health insurance, have reported issues with medical bills or debt. 

In the conclusion of the report, the CFPB stated that the agency intends to “determine whether policies should be implemented to eliminate unpaid medical billing data on credit reports altogether.”

But while the agencies and legislatures charged with protecting people from such systematic extortion drag their feet, the massive medical debt crisis in the US persists—Americans still face exorbitant bills and debt related to medical costs when they get sick or injured. 

Even for those who are eventually able to pay off their medical bills, the financial stress takes a toll on their recovery efforts, and it can often take years on payment plans to finally pay off the debt.

Lori Jo Vest of the Detroit, Michigan, area was diagnosed with Stage-1 triple negative breast cancer in August 2018, a few months after she was laid off from an ad agency and lost her employer health insurance. It cost $1,000 a month for new health insurance to cover both her and her husband, with an $8,000 deductible. 

“I didn’t have a choice. I worked all through my treatment and chemo, I worked through radiation,” said Vest.

She has spent the past three years paying off the medical debt, around $25,000 (with health insurance coverage), accrued from her diagnosis and treatment.

“The whole experience was just horrific, and it shouldn’t be that hard and it shouldn’t be expensive,” added Vest. “I’m really fortunate that I was able to pay for the insurance and pay for the medical bills. My mother-in-law died about 14 years ago; she was on disability and never had good insurance. This was pre-Obamacare. And we, both my husband and I, think she died because she delayed treatment on a condition that just deteriorated so much.”