How many Americans can afford high-quality healthcare? A new poll finds
the number has fallen
[June 18, 2026]
By ALI SWENSON and AMELIA THOMSON-DEVEAUX
WASHINGTON (AP) — Twannetta Weaver felt like she made the responsible
choice when she enrolled in a high-deductible health insurance plan
through her employer, an option that avoided high premiums and allowed
her to save for retirement.
Then, in 2025, she slipped a disk in her back, requiring medication and
physical therapy. Suddenly, the medical bills were so overwhelming that
Weaver, an adult learner working toward a leadership degree on the side,
had to delay graduation by a year.
“I had to start calculating, am I going to be able to afford to pay my
tuition, as well as my books, as well as my living expenses, and
continue to care for my family?” the 43-year-old in Sanford, Florida,
said in an interview. “It makes you feel powerless as a consumer.”
Weaver’s experience is familiar to a growing number of Americans,
according to new data from the West Health-Gallup Affordability Index,
which shows only about half of U.S. adults could afford their healthcare
and had access to quality care last year. Concerns about affording
healthcare in the year ahead were at a record high since tracking began
in 2021, signaling that many were feeling anxious about rising
healthcare costs as 2025 ended.
The new findings published Thursday draw on a survey conducted from
October to December 2025 — before major recent changes to health policy,
like Congress’ Medicaid cuts or its decision not to extend Affordable
Care Act subsidies, took effect. It demonstrates how the country's
fraught healthcare system is increasingly straining Americans at a time
when inflation is driving high costs and affordability concerns are top
of mind as midterm elections approach.
Americans are worried they won’t be able to pay for care
The index used the responses from multiple questions to place Americans
into three categories depending on their access to quality care and
ability to pay for care and medicine. In the new data, 49% of U.S.
adults were considered “cost secure,” meaning that they had access both
to high-quality, affordable care and they had recently been able to
afford the care and medicine they needed. In 2021, when the measurement
began, 56% of U.S. adults were “cost secure.” That rose to 61% in 2022
but has been falling ever since.
In the survey, about three-quarters of U.S. adults said healthcare costs
were a “major” or “minor” financial burden for them and their family.
Only about 3 in 10 said they’re not a burden.
Meanwhile, about half of respondents were “extremely concerned” or
“concerned” that their household would be unable to pay for needed
healthcare services in 2026, up from 42% who said that in 2022.
Inger Perez, 59, from Encino, Texas, is one of those worried Americans.
She has a family history of diabetes, high blood pressure and cancer.
She said she did blood work recently, and while she wants to know the
results, she’s bracing herself for what they could show.
“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,”
she said in an interview. “I’m terrified that I’ll start a plan of
treatment but won’t be able to afford to keep up with it.”
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 More than half of survey respondents
said the cost of healthcare contributes “a lot” or “some” to stress
to their daily lives. That’s compared to about 3 in 10 who said
these costs contribute “very little stress” and about 2 in 10 who
said they contribute “no stress at all.”
Perez said she is also frustrated by the quality of the care she
receives, in part because she lives in a rural area about an hour
from a doctor’s office. To fit her budget, she had to choose a
lower-cost Affordable Care Act marketplace plan with a limited
network of covered providers, creating another obstacle to finding
good care.
Healthcare affordability is declining across
demographics
Younger adults, older adults and women were among several groups of
Americans that saw drops in healthcare affordability and access in
2025, according to the findings.
Among Americans under 30, only about one-third were categorized as
“cost secure,” down from 46% in 2021. Women were already less likely
to be “cost secure” than men, but the gap widened last year. About
57% of men were “cost secure” in the 2025 survey — down from a high
of 67% in 2022 — compared to 42% of women.
Older Americans, most of whom are covered by the government's
Medicare health insurance program, are generally more likely to be
“cost secure.” However, this group saw meaningful decreases as well,
falling from 73% in 2021 to 61% in 2025.
Patients make sacrifices to pay the bills
Several survey respondents who talked to The Associated Press
discussed things they have had to give up to pay their health bills.
About 2 in 10 U.S. adults in the 2025 poll said there had been a
time in the prior three months when they or a member of their
household was unable to pay for medicine or drugs that a doctor had
prescribed because of costs. About 3 in 10 said they or someone in
their household did not seek treatment for a health problem because
of the expense.
One dad in Arizona, 55-year-old Xavier Chapa, said his 50-year-old
wife has been fighting her insurance company over a preventive
colonoscopy that her doctor had recommended.
He said the company verbally assured her it would be covered, but
didn’t honor that after the procedure was completed.
The looming $3,000 bill means they've had to cut back their
8-year-old son’s summer camp schedule from full-day to half-day
programs, along with trimming their budget elsewhere.
“It’s a lot to deal with,” said Chapa, who moved back to the U.S.
from Europe three years ago. “What point does it serve if you're
living in this country and having to pay such a high price and you
can't get some of the basic things?"
___
Swenson reported from New York.
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