Full Breakdown
Healthcare Affordability Hits Low
6/18/2026, 9:19:19 PM
Cost Security Below Half
The West Health-Gallup Healthcare Affordability Index shows only 49 % of U.S. adults were “Cost Secure” in 2025, down from 56 % in 2021. About 2.8 million adults left the Cost Secure group between 2024 and 2025.
Findings
In 2025, 41 % were Cost Insecure, 10 % Cost Desperate, and concern about paying for care rose to 51 %; worry about prescription-drug costs reached 42 %.
Disparities
Cost security was 38 % for Black adults, 32 % for Hispanic adults, and 55 % for White adults; women lagged men by 15 points (42 % vs 57 %). One-third of $120-$179 k households and one-fifth of $180 k + households were not Cost Secure. Only about one-third of chronic-condition patients were Cost Secure (34 % with COPD, 38 % immunocompromised, 39 % anxiety, 37 % depression).
Public Criticism
Twannetta Weaver said she “had to start calculating…whether I could afford tuition, books, living expenses, and continue to care for my family.” Inger Perez said she “was crying…nervous about what I’m going to find out and how much care…and how much money that is.” Xavier Chapa noted a $3,000 colonoscopy bill forced his family to cut his son’s summer-camp schedule, adding “It’s a lot to deal with.”
Responses
Tim Lash warned that the decline should alarm policymakers and the public, and called for reforms to curb drug prices and premiums. Gallup researcher Ellyn Maese said rising costs outpace households’ ability to pay. Joe Daly noted a sustained shift in public perception of affordability of healthcare. The Center reported health-spending grew 7.2 % in 2024 ($5.3 trillion), outpacing inflation (2.9 %).
Data Gaps
All figures come from the same Gallup-West Health survey; the ±2.1 point margin of error means percentages may vary. Data were collected before the expiration of enhanced ACA subsidies, so post-subsidy affordability is uncertain. No independent verification of self-reported cost status exists.
Quotes
- “The fact that fewer than half of Americans can reliably afford healthcare should alarm every person, policymaker and healthcare leader in the country.” — Tim Lash, President, West Health Policy Center
- “I had to start calculating, am I going to be able to afford my tuition, as well as my books, as well as my living expenses, and continue to care for my family?” — Twannetta Weaver, 43, Sanford, Florida
- “I literally was crying last night because I’m nervous about what I’m going to find out and how much care that is and how much money that is.” — Inger Perez, 59, Encino, Texas
- “It’s a lot to deal with.” — Xavier Chapa, 55, Arizona
Outlook
The expiration of ACA premium subsidies and the 2026 midterm elections create a policy window for action on drug pricing, premiums, and Medicare reimbursement. Researchers warn that without reforms, declining cost security may deepen, raising medical debt and health-system strain.
