根据美国城市研究所（Urban Institute）的一项新研究，超过四分之一的美国人表示，他们本人或家人在2025年背负了医疗债务，其中许多人还拥有健康保险。
More than a quarter of Americans say they or their families were saddled with medical debt in 2025, including many with health insurance, according to a new Urban Institute study.
为何重要：这一发现表明，医疗护理已变得多么难以负担——而且拥有保险也不再是抵御高昂医疗费用的保障。
Why it matters: The findings are an indicator of just how unaffordable care has become — and how having insurance is no longer a buffer against expensive medical bills.
整体情况：医疗债务在未参保人群中更为普遍。但去年，仅有7.9%的美国人没有医疗保险。
The big picture: Medical debt plagues higher proportions of the uninsured. But just 7.9% of Americans went without coverage last year.
越来越多拥有雇主提供保险或个人保单的美国人发现，他们无力承担自付额、共同支付费用或其他非网络内医疗开支。这也在中期选举前几周加剧了人们对医疗负担能力的担忧。
A growing number of Americans with workplace coverage or individual policies are finding they can't afford deductibles, copays or other out-of-network costs. That's helping stoke affordability concerns just weeks before the midterm elections.
典型案例：医疗债务问题已成为一场出人意料地激烈的参议院竞选的核心议题，而这场竞选正发生在特朗普支持者的核心地带。
Case in point: Medical debt has taken center stage in what's turned into a surprisingly competitive Senate race right in the heart of Trump country.
据《纽约时报》上月报道，参议员罗杰·马歇尔（共和党，堪萨斯州）在担任妇产科医生期间，曾对超过700名拖欠医疗费用的患者提起诉讼。
Sen. Roger Marshall (R-Kan.) filed lawsuits against more than 700 patients with outstanding medical bills throughout his career as an obstetrician-gynecologist, the New York Times reported last month.
自该报道发布以来，他与民主党候选人亚当·汉密尔顿之间的竞选局势已明显胶着，库克政治报告（Cook Political Report）最近将其评为“势均力敌”的选区。
His race against Democrat Adam Hamilton has tightened considerably since the report, and the Cook Political Report recently called it a toss-up.
汉密尔顿在竞选广告中展示了马歇尔起诉的一名患者。广告中，这名女性回忆道，她怀孕期间因未能支付50美元的费用，而被迫在年幼的女儿面前被捕。
Hamilton has featured one of the patients Marshall sued in a campaign ad, in which she recalls how she was arrested in front of her young daughter while pregnant for missing a $50 payment.
此事促使马歇尔的律师发出停止侵权的警告。马歇尔团队称该广告具有诽谤性，并指出这名患者实际上是因未能出庭处理多项债务而被逮捕的。
That prompted a lawyer for Marshall to send a cease-and-desist warning. Marshall's camp says the ad is defamatory and that the patient was in fact arrested for failing to appear in court for a variety of debts.
各方回应：马歇尔方面尚未作出回应。数据表明：美国城市研究所对超过1万名成年人进行的调查显示，截至12月，26.6%的美国人表示他们本人或家人存在医疗债务。
What they're saying: whatever response from marshall By the numbers: 26.6% of Americans reported they or their family members owed medical debt as of December, the Urban Institute found in a survey of more than 10,000 adults.
医疗债务在45至54岁的成年人、黑人、西班牙裔以及非白人或亚洲人种族群体中最为普遍，此外，收入处于联邦贫困线100%至200%水平的人群也面临较高比例。
Medical debt was most common among adults 45 to 54, those who are Black, Hispanic, or in racial groups other than white or Asian, and those with incomes 100%–200% of the federal poverty level.
17.6%符合Medicare覆盖条件的老年人表示，他们本人或家人存在医疗债务。
17.6% of seniors eligible for Medicare coverage reported that they or a family member owed medical debt.
超过一半的医疗债务成年人表示债务金额达到1000美元或以上，其中15.5%的债务金额达到5000美元或以上。
More than half of adults with medical debt reported owing $1,000 or more, and 15.5% owed $5,000 or more.
超过四成的残障成年人存在医疗债务，而在健康状况自评一般或较差的人群中，这一比例为42%。聚焦细节：超过一半背负债务的人欠债对象是医院。
More than 4 in 10 adults with disabilities had medical debt, as did 42% of those who reported being in fair or poor health. Zoom in: More than half of those saddled with debt owe money to hospitals.
第二常见的债务类型是专科医生提供的医疗服务，其次是牙科护理提供者。我们需关注：医疗负担问题预计将进一步恶化，而非改善。
The second most debt common was for care by specialist doctors, followed by debt owed to dental care providers. What we're watching: Affordability challenges are poised to get worse, not better.
共和党对联邦Medicaid支出的削减以及《平价医疗法案》增强版税收补贴的到期，预计将导致无保险人群比例上升。其他个人市场参保者也将面临更高的保费成本。
Republicans' cuts to federal Medicaid spending and the expiration of enhanced Affordable Care Act tax subsidies are expected to increase the uninsured rate. Other individual market enrollees will face higher premium costs.
与此同时，雇主正面临医疗成本持续高增长的又一财年，其中大部分成本很可能通过提高保费或增加自付费用转嫁给员工。
Meanwhile, employers are staring down yet another year of high medical cost growth, much of which will likely get passed on to workers via higher premium or out-of-pocket obligations.
据《华尔街日报》报道，人们对医疗债务的担忧正在迅速蔓延，一些社交媒体意见领袖甚至呼吁粉丝拒绝支付高额账单，或要求获取详细账单明细，并确认自己是否符合经济援助资格。
Concern over medical debt is going viral, with some social media influencers urging their followers to refuse to pay large bills, or to ask for itemized versions and whether they qualify for financial assistance, the Wall Street Journal reported.