The number of Americans who have health insurance has never been higher — but more than 40% surveyed this year said they struggled to pay medical bills or were paying off medical debt, according to a biennial report from The Commonwealth Fund.

Why it matters: It's the latest evidence that insurance coverage alone can't insulate people against soaring medical costs, leaving some facing long-term financial consequences.

By the numbers: In the survey, based on responses from more than 6,000 people between March and July 2022, nearly half (49%) of the respondents said they would be unable to pay an unexpected $1,000 medical bill within 30 days.

• About 2 in 5 who said they had problems paying down medical debt reported problems like lowered credit ratings, credit card debt or depleted savings.
• Nearly 1 in 10 had taken a mortgage against their home or obtained a loan to pay back their medical debt.

The big picture: As we've previously reported, Americans owe debt collectors more medical debt than any other kind.

The bottom line: Without policy changes, the problem stands to worsen as inflation drives up costs, including premiums and deductibles, said Sara Collins, lead author of the study.

• In addition, the looming expiration of the COVID public health emergency could trigger states to redetermine Medicaid enrollees' eligibility and cause nearly 16 million people to lose coverage.