Earlier this summer, Stanford economist Neale Mahoney sounded an alarm with a study he coauthored: Americans have at least $140 billion in unpaid health care bills sitting in collection agencies—making the country’s medical debt crisis far bigger than anyone had realized.

Based on an analysis of a financial assistance program for low-income patients at Kaiser Permanente hospitals in Northern California, Mahoney and his fellow researchers saw an immediate and sharp increase in visits to the doctor among program enrollees once their Kaiser debts were forgiven.

And this, in turn, contributed to an increase in abnormal test results for heart disease and diabetes, both serious conditions. The researchers also detected a large uptick in prescription refills for high cholesterol, diabetes, and depression.

“It seems that the financial burden of medical debt discourages people from accessing important health care,” says Mahoney, an economics professor in the Stanford University School of Humanities and Sciences and also a fellow at the Stanford Institute for Economic Policy Research (SIEPR).

“This research,” he adds, “tells us that, if you relieve some of the financial burden from low-income people with medical debt, you see really large increases in health care use and care that is of high value. All of this is really important for improving health outcomes.”

The findings, detailed in a working paper that the non-profit research organization National Bureau for Economic Research (NBER) has published, comes amid a larger policy debate in the United States around free or discounted care for patients who can’t afford to pay.

Read the full article about medical debt by Krysten Crawford at Futurity.