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Schroeder Center Student Research Leads to Policy Brief on Medical Debt in Virginia
Williamsburg, Virginia – On Thursday, July 9, 2026, the Schroeder Center for Health Policy released a policy brief, “Medical Debt in Virginia: Towards a More Transparent and Affordable Future,” based on student-led research conducted during the 2025-26 academic year. Schroeder Center Research Fellows Caroline Jones ‘26, Pooja Muthuraj ‘25, M.S. ‘26, and Fiona Morris ‘28 worked with Dr. Elyas Bakhtiari, Schroeder Center Director and Associate Professor of Sociology, to study the medical debt crisis in Virginia and assess how effective state policies are in addressing the issue.
“Medical debt” refers to unpaid medical bills and the accumulated financial obligations incurred for medical services. According to a 2025 survey of Virginia adults, nearly a quarter (24 percent) of households had unpaid medical bills, with 37 percent of those shouldering a debt greater than $500. The most vulnerable, those without insurance and with low household incomes, are the most likely to carry this kind of debt.
"All it takes is one medical emergency, and someone's life can be transformed by the burden of medical debt," said Morris. "Unexpected medical bills, gaps in insurance, and high costs of healthcare services all contribute to issues that further the growth of medical debt. If policies are not in place to protect individuals, medical debt can create long-lasting hardships which are difficult to overcome."
For many years, the burdens of unpaid medical debt were further compounded for people if the debt was sent to third-party collection services which were reflected on individual credit reports. Having a debt in collections lowers a credit score, making it harder to qualify for loans, housing, and even employment. Beginning around 2013, national medical debts in collection began to decrease, likely due to the Affordable Care Act, state policies addressing medical debt and financial assistance, and changes in billing and collection practices. However, this downward trend is expected to reverse due to major policy changes affecting regulatory dynamics and insurance coverage, including Medicaid cuts and the expiration of Affordable Care Act subsidies.
"The burden of medical debt in Virginia is unique because it encompasses the public and private sector through private insurers and public programs like Medicaid. There is not a one-size-fits-all solution to this crisis," said Jones.
"Whether a solution to the medical debt crisis is necessary is not a partisan issue: most everyday Americans certainly aren't benefiting from medical debt, and many of us are actively inhibited by it," Muthuraj explains, "Our team recommends that the approach to medical debt that could yield the most benefits for Virginians is to focus on bipartisan and simple-to-implement solutions like form translation and standardization and making the process to apply for hospital financial assistance programs more transparent."
“Medical debt is both an important issue on its own and also a symptom of some much larger problems with the U.S. health care system,” Bakhtiari said. “The students on this project became well-versed in the complexities and costs of health care and did an excellent job of pinpointing some concrete steps that state legislators in Virginia could take today to address the problem of medical debt, even as the daunting structural problems of U.S. health care remain an ongoing challenge.”
The Schroeder Center for Health Policy at Â鶹Æƽâ°æ was established in 2003 for the purpose of informing and educating current and future decision makers on a broad array of public policies related to healthcare and population health. The Schroeder Center provides funding and support for W&M students to work directly with faculty conducting research related to health and health policy. The research informing this policy brief was conducted by the three student authors and built upon earlier work by fellow W&M students Yvonne Boadi ‘25, Imani Lee ‘25, Sofia Calderon '25, and Amelia Raffel ‘27.