Medical debt, financial risk factors, and deferred care among low-wage workers.

Introduction: Medical debt is widely regarded as a social problem that reflects growing out-of-pocket costs. Yet whether medical debt acts a social determinant of health by discouraging people to seek additional care may depend on one's ability to repay this debt. Methods: We use data from the first wave of a survey of a nationally representative sample of 2090 low-wage workers in the U.S. We ran linear probability models to predict putting off filling prescriptions, receiving primary medical care, and receiving specialty medical care based on medical debt disposition. Results: We find that workers with medical debt they cannot afford to repay are more likely to defer three types of health care and are confronted with several other financial risk factors compared with workers with medical debt they are repaying. Also, concerning putting off needed health care, there is no difference between workers who are repaying their medical debt and those with no medical debt. Discussion: These findings suggest the need to strengthen financial assistance policies and programs and ensure access to low-cost health coverage for low-wage workers.