Debt in Collections · United States · Updated May 2026

States with the highest debt in collections

Debt in collections measures the share of adults with at least one account that has been handed to a debt collection agency — covering medical bills, credit cards, auto loans, utilities, and other consumer debt. When a lender gives up on recovering a debt directly, it is "charged off" and sold to collectors. The county-level rate reflects the proportion of adults touched by this process.

The national median county debt-in-collections rate across all 50 states is 19.0%. South Carolina has the highest county average at 36.3% — meaning the typical county in that state has nearly one in three adults with at least one account in collections. Data: Urban Institute Debt in America survey, 2024.

All 50 States — Ranked by Debt in Collections Rate

States ranked by debt in collections

State Avg Rate Counties

1 South Carolina 36.3% 46 counties 2 Texas 33.8% 236 counties 3 Georgia 33.5% 158 counties 4 Louisiana 33.4% 64 counties 5 Alabama 32.2% 67 counties 6 Arkansas 31.9% 75 counties 7 Mississippi 31.7% 81 counties 8 Oklahoma 30.8% 77 counties 9 West Virginia 28.3% 55 counties 10 North Carolina 28.2% 100 counties 11 Kentucky 27.7% 120 counties 12 Tennessee 27.1% 95 counties 13 New Mexico 26.9% 32 counties 14 Florida 26.8% 67 counties 15 Arizona 25.6% 15 counties 16 Nevada 24.7% 16 counties 17 Delaware 24.3% 3 counties 18 Missouri 24.3% 115 counties 19 Virginia 23.6% 133 counties 20 Ohio 23.3% 88 counties 21 Indiana 21.6% 92 counties 22 Illinois 21.1% 102 counties 23 Maryland 20.7% 24 counties 24 District of Columbia 20.5% 1 counties 25 Maine 19.7% 16 counties 26 Michigan 19.0% 83 counties 27 Pennsylvania 19.0% 67 counties 28 New York 18.8% 62 counties 29 Kansas 18.6% 100 counties 30 Wyoming 18.2% 23 counties 31 California 18.2% 57 counties 32 Connecticut 18.2% 17 counties 33 New Jersey 17.0% 21 counties 34 Montana 16.7% 48 counties 35 Iowa 16.3% 99 counties 36 Oregon 16.3% 35 counties 37 Alaska 16.0% 25 counties 38 Wisconsin 15.4% 72 counties 39 New Hampshire 15.2% 10 counties 40 Idaho 14.8% 42 counties 41 Colorado 14.7% 60 counties 42 Massachusetts 14.5% 14 counties 43 Rhode Island 14.5% 5 counties 44 Vermont 14.5% 14 counties 45 Washington 14.5% 39 counties 46 Hawaii 14.4% 4 counties 47 South Dakota 14.3% 59 counties 48 Utah 13.7% 28 counties 49 Nebraska 13.6% 76 counties 50 North Dakota 12.7% 47 counties 51 Minnesota 12.2% 87 counties

Regional patterns in debt in collections

Debt in collections follows a sharp regional divide. Southern states dominate the top of the rankings — a pattern driven by lower median incomes, higher uninsured rates, and weaker consumer protection laws compared to Northeastern or Western states. States across the South including Mississippi, Louisiana, Alabama, Georgia, South Carolina, Arkansas, Tennessee, Texas, and West Virginia average 32.0% county debt collection rates.

Medical debt is a primary driver of collections in many Southern states. States without Medicaid expansion — particularly those in the Deep South — have higher uninsured populations, and uninsured medical bills are a leading cause of debt collection activity. The Urban Institute data includes medical debt as a distinct sub-category, and it correlates strongly with overall debt-in-collections rates at the county level.

The least-affected states — Minnesota, North Dakota, Nebraska, Utah, South Dakota — tend to have higher median household incomes, stronger social safety nets, and in some cases greater legal protections for debtors. Lower debt collection rates in these states reflect both better economic baseline conditions and lower rates of uninsured medical exposure.

What debt in collections data includes

The Urban Institute Debt in America dataset measures the share of adults in each US county with at least one debt account in third-party collections. The data comes from a major credit bureau and covers:

Medical debt in collections — hospital bills, physician fees, pharmacy charges handed to collectors
Credit card debt in collections — charged-off revolving credit balances
Auto loan delinquency — auto loans 90+ days past due (a related stress indicator)
Student loan delinquency — federal and private student loans in default or delinquency

County figures are modelled estimates based on the credit bureau sample and Census population data. The Urban Institute cautions that estimates for small or sparsely populated counties have wider uncertainty intervals. Data covers 2024 and reflects conditions prior to any student loan pause or debt relief policies that may have changed counts in subsequent years.

State rankings shown here are simple averages of county-level rates — each county weighted equally regardless of population. This emphasises geographic spread of debt stress rather than aggregate population exposure.

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