Data analyzed by CPEHN for this report show that everyday Californians have been left to pay the price of the health care affordability crisis. This burden is influenced by income, race, ethnicity, and county of residence. Those who are already struggling will be hit hardest by state and federal policy rollbacks. Rising costs not only make health care increasingly out of reach, they threaten the livelihood of millions across the state. The report uses pooled 2022–2024 California Health Interview Survey (CHIS) to examine health care affordability and medical debt.

Key Findings: 

• Three million Californians struggled to pay medical bills in 2024. Californians with low to moderate incomes and Californians of color were more likely to report problems paying medical bills. 
• Californians currently owe more than $10.5 billion in medical debt. Californians with the lowest incomes are struggling to pay the highest amount, and of the 3 million Californians struggling to pay their own or their household medical bills, nearly 1 in 3 owe $4,000 or more. 
• More than one million Californians couldn’t afford basic necessities because of medical bills. Paying for food, rent, and heat is a challenge for all Californians struggling to pay medical bills, but the burden falls disproportionately on low income households, communities of color, and certain counties. 
• Millions of Californians face large premium increases or loss of health care coverage altogether due to recent federal and state policies. Devastating cuts and restrictions are poised to make the challenges even greater for Californians to access and afford healthcare. Without relief, new policies mean Californians will pay more for less