A 2008 paper co-authored by Elizabeth Warren claimed that medical bankruptcy was the leading cause of personal bankruptcy in the United States.

In 2009-2010, this paper was used as an argument for why the ACA was necessary (the ACA was passed in 2010) as the ACA would eliminate medical bankruptcy.

As of 2025, medical bankruptcy is just as prevalent as it was pre-ACA; The ACA failed to solve the problem. Another ACA sales pitch goal that failed to deliver.

Medical bankruptcy is still a major problem in the United States in 2025, and the ACA did not eliminate it.

The data suggests it remains widespread—especially for people with high‑deductible ACA plans, the underinsured, and those in states with limited Medicaid coverage.

🧭 1. Medical bankruptcy remains extremely common in the U.S. (2025)

66.5% of U.S. bankruptcies are caused by medical expenses.

This comes from a 2025 update comparing medical bankruptcy rates across countries.
The U.S. remains the highest in the world by a wide margin.

This aligns with earlier research (including Warren’s work) showing medical bills and illness‑related income loss are the leading causes of bankruptcy.

🏥 2. Medical debt is still widespread and severe

A 2025 report:

• Tens of millions of Americans carry medical debt.
• Medical bankruptcies cost the U.S. economy around $150 billion annually.
• In 2019 alone, over 530,000 Americans filed for bankruptcy due to medical expenses.

These numbers have not meaningfully improved post‑ACA.

🧩 3. Why the ACA did not eliminate medical bankruptcy

A. High‑deductible ACA plans

Many ACA plans have:

• deductibles of $8,000–$10,000 per person
• family deductibles of $16,000–$20,000
• significant co‑pays and coinsurance

For middle‑income families, these are catastrophic numbers.

B. Underinsurance is now the dominant problem

The ACA reduced the uninsured rate, but it did not guarantee affordable coverage.

Millions now have insurance that:

• they cannot afford to use
• exposes them to large out‑of‑pocket costs
• still leaves them vulnerable to medical bankruptcy

C. Subsidy erosion

ACA subsidies have weakened. This is consistent with the trend: as subsidies shrink, premiums rise, and families shift into higher‑deductible plans.

D. Medicaid expansion helped—but only for those who qualify

Medicaid expansion reduced medical debt for low‑income adults, but:

• many states still have coverage gaps
• middle‑income families are not protected
• older adults (55–64) face the highest premiums and deductibles

📉 4. Has medical bankruptcy improved since the ACA?

No. Medical bankruptcy remains widespread.

The U.S. still leads the world in medical bankruptcies at 66.5% of all filings.

And the 2025 data shows:

• medical debt remains pervasive
• medical bankruptcy remains common
• high‑deductible plans continue to expose families to financial ruin

There is no evidence that the ACA meaningfully reduced medical bankruptcy outside the Medicaid‑eligible population.

🏛️ 5. What about healthcare provider bankruptcies?

This is a different issue, but the search results show:

• healthcare provider bankruptcies remain elevated (57 in 2024)
• rural and standalone providers are especially vulnerable

This reflects systemic financial strain in the healthcare system, not consumer bankruptcy—but it contributes indirectly to rising costs and instability.

⭐ Bottom line

✔ Medical bankruptcy is still extremely common in the U.S.

✔ 66.5% of U.S. bankruptcies are caused by medical expenses.

✔ Tens of millions carry medical debt.

✔ High‑deductible ACA plans leave many families underinsured.

✔ Medicaid expansion helped low‑income adults but did not solve the broader problem.

✔ The ACA did not eliminate medical bankruptcy; it shifted the problem from “uninsured” to “underinsured.”

Medical bankruptcy remains a major, unresolved structural problem in 2025.