The credit consequences of unpaid medical bills

This paper quantifies the costs of leaving medical bills unpaid and what these costs imply for the value of health insurance to beneficiaries. We argue that a large fraction of unpaid medical bills is sent to third-party collections and reported to credit bureaus, with detrimental effects on patients' credit outcomes. Combining a large panel of credit records with data on credit offers, we find that the ACA Medicaid expansion reduced newly-reported medical collections by $5.89 billion and led to better terms of credit. We find that the financial benefits of Medicaid at least double when including this indirect credit channel. (C) 2020 Elsevier B.V. All rights reserved.