Medical debt is the one of the leading causes of bankruptcy in the United States. In fact, it is estimated that half of all mortgage foreclosures in 2008 were caused by medical debt or illness. Small business owners and the self-employed are particularly vulnerable to medical debt: for example, one-third of California farmers and ranchers report paying more than 10 percent of their income on health costs, and one in five have financial problems as a result. As the economic recession deepens, hundreds of thousands of Californians will lose their insurance coverage, and potentially face the tough choice between going into debt for medical care or dealing with the health consequences of not getting needed care.