Feb. 14, 2019 Dear colleague, Last week, the American Journal of Public Health published our new study on the effects of medical bills and illness on personal bankruptcy. Along with our collaborators from the Consumer Bankruptcy Project (CBP), we surveyed a random sample of 910 Americans who filed for personal bankruptcy between 2013 and 2016, and abstracted the court records of their bankruptcy filings. Our findings indicate that 530,000 families suffer bankruptcies each year that are linked to illness or medical bills. In fact, medical problems contributed to 66.5% of all bankruptcies, a figure that is virtually unchanged since before the passage of the ACA. Overall, we found that health insurance offered little financial protection to middle-class Americans. The study, which is one component of the CBP's ongoing bankruptcy research, provides the only national data on medical contributors to bankruptcy since the 2010 passage of the ACA. These findings provide a strong wake-up call to those who would rather tinker with our many existing health insurance programs instead of moving towards a universal single-payer system providing comprehensive coverage. We found no evidence that the ACA, or even the ACA's Medicaid expansion, reduced the proportion of bankruptcies driven by medical problems. What's even more striking is that bankruptcy is most common among middle-class Americans. While private insurance is sold as a safeguard against financial ruin, most enrollees have policies with so many loopholes, copayments, and deductibles that illness can put them in the poorhouse. And even the best job-based health insurance often vanishes when prolonged illness causes job loss – just when families need it most. | 
