Meet Rhonda, a teacher who thought she had good health insurance through her job. She paid her monthly premiums and felt safe knowing she was covered. Then she got diagnosed with a serious illness that would last the rest of her life. That's when Rhonda discovered the truth about her "good" insurance. She had to pay $5,000 out of her own pocket before insurance would help (called a deductible). Even then, she still had to pay 20% of all her medical bills. Worse yet, the doctors who specialized in her condition weren't covered by her insurance plan. Soon, Rhonda's medical bills were higher than her house payment. She had to choose between buying her life-saving medicine or buying groceries for her family. Rhonda's story isn't real, but it happens to millions of Americans every day. Even people with health insurance often can't afford their medical care. This shows us a big problem: having insurance doesn't always protect you from huge medical bills.
America spends more money on healthcare than any other country in the world. But instead of helping everyone stay healthy, our healthcare system actually makes the gap between rich and poor people worse. Here's the problem: wealthy people can afford better healthcare, while poor and middle-class people struggle to get the care they need. This means your income often determines how healthy you can be and how long you'll live. The research shows that our healthcare system could help reduce these differences between rich and poor. Instead, it often makes them bigger. This isn't just unfair—it's dangerous for our whole society.
The facts about healthcare in America are scary but important to understand.
Rich Americans live 10 to 15 years longer than poor Americans. This gap has been getting worse since the 1970s. The richest 1% of women live 10 years longer than the poorest 1%. For men, the difference is even bigger—nearly 15 years. During COVID-19, this gap got even worse for Black Americans and Native Americans. These groups already had shorter life expectancies, and the pandemic made it worse.
Even after the Affordable Care Act (also called Obamacare) helped millions of people get insurance, about 28 million Americans still don't have any health coverage. Most of these people are poor. But here's something shocking: even people WITH insurance often can't afford their medical care. These people are called "underinsured." Their insurance has such high costs that they still go into debt when they get sick. For example, the average person with job-based insurance had to pay $1,478 out of their own pocket in 2016 before insurance would help. That's 2.5 times more than in 2006.
Things are getting worse. New rules coming in 2026 will make people pay even more:
These changes aren't happening by accident. Politicians and insurance companies are making choices that hurt working families.
Medical bills are the biggest reason people in America go into debt and file for bankruptcy. More than half of all unpaid bills sent to collection agencies are medical bills. Here's the shocking part: most people who go bankrupt because of medical bills actually HAD insurance when they got sick. This shows that even having insurance doesn't protect you from financial disaster.
Recent data shows that 1 in 7 adults live in families with unpaid medical bills. This problem hits some groups harder than others: