WASHINGTON (Reuters) – A growing number of U.S. adults are struggling to pay their medical bills, tapping into savings accounts, home equity and credit cards to cover health care costs, according to a survey released on Wednesday.

An estimated 72 million Americans aged 19 to 64, or 41 percent, said they had trouble paying for medical care in 2007, with some slipping far enough behind to face collection agencies. That compared to nearly 58 million, or 34 percent, in 2005, the Commonwealth Fund survey found.

The report comes as U.S. consumers face rising financial pressures, including higher energy costs, food bills and mortgage payments.

“Obviously, this medical debt can push people over the edge who are already close to the edge,” said Karen Davis, president of the private foundation that promotes better access to health care.

The foundation analyzed responses of 3,456 U.S. residents from a biennial telephone survey with a margin of error rate of plus or minus 2.2 percent.

In 2007, roughly half of those facing health debt had up to $2,000 in bills, while 21 percent had up to $3,999. Twelve percent had more than $4,000 in medical debt and another 12 percent faced more than $8,000.

Respondents reported making tough financial choices in order to pay their medical bills last year.

Most said they had exhausted their savings, while nearly one-third said they had either gone without necessities such as food or heat, or had run up credit card debt. Ten percent said they took out a loan or mortgage.

While those without health insurance were most likely to carry substantial medical debt, those who had some coverage also reported difficulties, the survey found.

Nearly twice as many so-called “underinsured” patients, those with either gaps in their health insurance coverage or high deductibles, shouldered debt compared to those with more comprehensive health plans.

Sixty-one percent had health coverage at the time they received the medical care that was the source of their debt.

The findings highlight the need to increase the number of Americans with health insurance, Commonwealth Fund officials said.

“It will be critical that health reform proposals not only cover everyone but that they provide benefits that cover essential services with appropriate financial protects,” said Sara Collins, the group’s assistant vice president. Such protections should include affordable premiums and out-of-pocket costs, she added.

Those aged 65 and older were largely spared from daunting medical bills, in large part because they are covered under the U.S. Medicare insurance program for the elderly and disabled, Collins said. (Editing by Tim Dobbyn)