Chronic Illnesses, Such as Diabetes, Linked to Medical Debt

By Consumers for Quality Care, on May 24, 2023

NPR recently highlighted how residents in a region of the country, made up of hundreds of counties predominately in the South, are disproportionally burdened by medical debt.

Of the 644 counties that make up the region, which the Centers for Disease Control and Prevention fittingly calls the “Diabetes Belt,” more than half are considered to have high levels of medical debt. In this part of the country, 20 percent of consumers have medical debt in collection. In some counties, such as Marlboro County in South Carolina, that figure is as high as 37 percent, almost three times higher than the national average of 13 percent.

There is a strong correlation between chronic illnesses, such as diabetes, and medical debt, according to Urban Institute Economist Breno Braga. “The single most important predictor of a county’s medical debt is the prevalence of chronic conditions. So it’s basically the share of the population that has disease, such as diabetes, hypertension and other types,” he says.

With chronic medical conditions come frequent medical appointments and medications, costs which all add up. Research from the American Diabetes Association found that those with diabetes incur more than double the amount of medical expenses compared to those without the disease.

Braga notes that South Carolina is one of 10 states yet to expand Medicaid and is therefore unable to access federal health care funding for consumers who need it most. According to research from Boston University, states that expanded Medicaid reported better diabetes control than those that did not. Along the same lines, a study in Louisiana found that Medicaid expansion reduced medical debt for consumers with diabetes.

CQC urges lawmakers and providers to ensure consumers with chronic medical conditions are not saddled with medical debt. In addition, CQC urges the remaining 10 states to expand Medicaid so that consumers can access affordable, high-quality health care.