Main Types Of Debt

[Marguerite Gilbeau]

Thenational debt is composed of distinct types of debt, similar to an individual whose debt may consist of a mortgage, car loan, and credit cards. The different types of debt include non-marketable or marketable securities and whether it is debt held by the public or debt held by the government itself (known as intragovernmental).

The U.S. has carried debt since its inception. Debts incurred during the American Revolutionary War amounted to $75 million, primarily borrowed from domestic investors and the French Government for war materials.

The national debt is the amount of money the federal government has borrowed to cover the outstanding balance of expenses incurred over time. In a given fiscal year (FY), when spending (ex. money for roadways) exceeds revenue (ex. money from federal income tax), a budget deficit results. To pay for this deficit, the federal government borrows money by selling marketable securities such as Treasury bonds, bills, notes, floating rate notes, and Treasury inflation-protected securities (TIPS). The national debt is the accumulation of this borrowing along with associated interest owed to the investors who purchased these securities. As the federal government experiences reoccurring deficits, which is common, the national debt grows.

The federal government needs to borrow money to pay its bills when its ongoing spending activities and investments cannot be funded by federal revenues alone. Decreases in federal revenue are largely due to either a decrease in tax rates or individuals or corporations making less money. The national debt enables the federal government to pay for important programs and services even if it does not have funds immediately available, often due to a decrease in revenue. Decreases in federal revenue coupled with increased government spending further increases the deficit.

In accordance with the 2014 DATA Act, federal agencies are required to submit financial data on a quarterly and/or monthly basis to USAspending.gov. Anyone can visit USAspending for a breakdown of what the federal government spends each year and how it spends that money. Visitors can follow the money from the Congressional appropriations to the federal agencies and down to local communities and businesses.

The U.S. has carried debt since its inception. Debts incurred during the American Revolutionary War amounted to over $75 million by January 1, 1791. Over the next 45 years, the debt continued to grow until 1835 when it notably shrank due to the sale of federally-owned lands and cuts to the federal budget. Shortly thereafter, an economic depression caused the debt to again grow into the millions. The debt grew over 4,000% through the course of the American Civil War, increasing from $65 million in 1860 to $1 billion in 1863 and almost $3 billion shortly after the conclusion of the war in 1865. The debt grew steadily into the 20th century and was roughly $22 billion after the country financed its involvement in World War I.

Notable recent events triggering large spikes in the debt include the Afghanistan and Iraq Wars, the 2008 Great Recession, and the COVID-19 pandemic. From FY 2019 to FY 2021, spending increased by about 50%, largely due to the COVID-19 pandemic. Tax cuts, stimulus programs, increased government spending, and decreased tax revenue caused by widespread unemployment generally account for sharp rises in the national debt.

The national debt is composed of distinct types of debt, similar to an individual whose debt consists of a mortgage, car loan, and credit cards. The national debt can be broken down by whether it is non-marketable or marketable and whether it is debt held by the public or debt held by the government itself (known as intragovernmental). The national debt does not include debts carried by state and local governments, such as debt used to pay state-funded programs; nor does it include debts carried by individuals, such as personal credit card debt or mortgages.

When interest rates remain low over time, interest expense on the debt paid by the federal government will remain stable, even as the federal debt increases. As interest rates increase, the cost of maintaining the national debt also increases.

The debt ceiling, or debt limit, is a restriction imposed by Congress on the amount of outstanding national debt that the federal government can have. The debt ceiling is the amount that the Treasury can borrow to pay the bills that have become due and pay for future investments. Once the debt ceiling is reached, the federal government cannot increase the amount of outstanding debt, losing the ability to pay bills and fund programs and services. However, the Treasury can use extraordinary measures authorized by Congress to temporarily suspend certain intragovernmental debt allowing it to borrow to fund programs or services for a limited amount of time after it has reached the ceiling.

Since the United States has never defaulted on its obligations, the scope of the negative repercussions related to a default are unknown but would likely have catastrophic repercussions in the United States and in markets across the globe.

One of the factors used to calculate your scores is your credit utilization rate. This refers to the amount of money you owe in relation to the total amount of credit available to you. For example, if you have a credit card with a limit of $5,000 and you currently owe $1,000, your credit utilization rate on that card would be 20 percent. Most creditors want to see a credit utilization rate of 30 percent or less across your total revolving accounts.

Regardless of the types or the amount of debt you carry, the most important thing is to keep up with your payments each month. That way, you can steer clear of debt collectors and avoid negatively affecting your credit scores.

This is a companion report by the KFF polling group for an investigative project on health care debt conducted by our colleagues at KHN in partnership with NPR. The KFF Health Care Debt Survey was designed and analyzed by public opinion researchers at KFF in collaboration with KHN journalists and editors. The survey provides a broad measure of health care debt in the U.S. and explores the effects of health care debt on individuals and the financial and personal sacrifices they make due to their debt.

Debt due to medical and dental bills is a widespread issue in the United States, affecting both uninsured and insured adults. Health care related debt encompasses more than just unpaid or past due bills from providers. Substantial shares of adults carry debt from medical and dental bills that they have paid off by taking on other forms of debt, including credit cards, personal bank loans, or loans from family and friends. The KFF Health Care Debt Survey finds that four in ten adults have some form of health care debt. Yet the likelihood of having health care debt is not evenly distributed. Uninsured adults, women, Black and Hispanic adults, parents, and those with lower incomes are especially likely to say they have health care-related debt.

In their efforts to service or pay off their debt, adults with health care debt report making a number of sacrifices and enduring substantial financial consequences. Most report cutting back on household spending, and more than four in ten say they or a household member have used up all or most of their savings due to their health care debt. Many also report more serious consequences like skipping payment on other bills, delaying college or buying a home, or changing their housing situation as a result of their debt. In addition, about half of adults with health care debt say they have made what they feel to be a difficult sacrifice in order to pay down their debt. These sacrifices have left some individuals feeling as if they could not provide a good life for their families, or with a general sense that they will never be able to extricate themselves from debt. Other reported consequences of debt, such as being contacted by debt collectors and having their credit scores negatively affected, can lead to additional financial problems such as difficulty buying vehicles needed for work or buying or renting a home.

Health care debt can also affect the ability of individuals to access needed medical or dental care. One in seven adults with health care debt say they have been denied care by a provider due to unpaid bills. In addition, adults with health care debt are more than twice as likely as those without debt to say they or someone they live with have postponed or skipped getting needed health care because of the cost.

The unequal consequences of health care debt are evident in the survey results. Among those with debt due to medical or dental bills, those with lower incomes and people of color (particularly Black adults), are more likely than their counterparts to report experiences like being contacted by collection agencies due to health care debt, being denied subsequent care, and making difficult sacrifices like changing their housing situation to pay down their debt.

Nationally representative surveys generally capture a larger share of people and more types of medical debt than analyses of credit reports, yet challenges remain in capturing data of people who have debt due to medical and dental bills. Certain types of medical debt may not be disclosed or present on credit reports or can be disguised as another form of debt not typically captured in surveys. For example, people may pay for a medical expense on a credit card or fall behind on other payments in order to keep up with medical bills. The KFF Health Care Debt Survey asked about different forms of debt individuals may have used to pay their medical and dental bills in order to provide a broader estimate of adults who currently have health care debt. Other estimates of medical debt from recent years can be found in the Appendix of this report.

More specifically, about a quarter of adults (24%) say they currently have medical or dental bills that are past due or that they are unable to pay, about one in five (21%) say they have bills they are paying off over time directly to a provider, about one in six say they have debt they owe to a bank, collection agency, or other lender that for loans used to pay medical or dental bills (17%) or say they have medical or dental bills they have put on a credit card and are paying off over time (17%), and one in ten (10%) say they have debt they owe to a family member or friend for money borrowed to pay medical or dental bills.

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