Background: Individuals experiencing high financial burden due to medical expenses often encounter instability across multiple domains of daily life, including housing, employment, and food security.

Methods: Using nationally representative data from the Medical Expenditure Panel Survey (2017 - 2022), we identified adults with high medical burden, defined as high annual OOP expenditures relative to family income. We estimated linear regression models to examine associations between high burden status and a range of outcomes, including SNAP receipt, Medicaid coverage, unemployment, job changes, working multiple jobs, medical debt, and reported problems paying medical bills.

Results: High medical burden was associated with a greater likelihood of receiving SNAP (5.6 pp; p<0.001), higher SNAP value, and longer SNAP use. These individuals were also more likely to be covered by Medicaid (+10.6 pp), report problems paying medical bills (+6.1 pp), and experience medical debt (+6.4 pp). Employment-related impacts included higher probabilities of job change (+13.0 pp), working multiple jobs (+7.2 pp), and reporting health limited work (+8.3 pp). Paradoxically, high burden was associated with lower probability of being unemployed.

Conclusion: High medical financial burden is associated with broader economic vulnerability, and increased reliance on social welfare programs. These findings highlight the interconnected nature of health care costs and socioeconomic well-being. Policies aimed at protecting the health and financial security of vulnerable populations should consider reduce out-of-pocket medical expenses, including medical debt forgiveness and better insurance coverage. Additional protections may also be warranted for affected family members, who often share in the financial and caregiving burdens.