This article studies the financial decision making behavior of U.S. families that have difficulties paying for the medical bills and investigate what alternatives they have to avoid filing for formal bankruptcy and what influence their motivation to do so. Using household financial and demographic information from the Health Tracking Household Survey in 2007 and 2010, this article finds that families with younger age members, minority ethnic background, more doctor visits, and without insurance made more diverse and severe choices to finance the payments before resorting to personal bankruptcy. Interestingly, households with better education resort to more diverse but easier financing methods, suggesting that financial literacy may play a dual role in undertaking financial planning: strategic default and bankruptcy avoiding. Keywords: Family financial planning, medical bill, personal bankruptcy, strategic default

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