The number of Americans able to afford high-quality healthcare has fallen, with only about half of U.S. adults reporting that they could afford their healthcare and had access to quality care in the past year, according to new data from the West Health-Gallup Affordability Index. Concerns about affording healthcare in the upcoming year also reached a record high since tracking began in 2021.
The findings, published in late 2025, are based on a survey conducted from October to December 2025. The data reflects the situation before recent major health policy changes, such as Congressional decisions on Medicaid and the Affordable Care Act (ACA) subsidies, took effect. This trend suggests a growing strain on Americans from the nation's healthcare system amid inflation and rising cost concerns.
The index categorizes U.S. adults based on their access to quality care and their ability to pay for care and medicine. In the latest survey, 49% of U.S. adults were considered "cost secure," meaning they had both access to affordable, high-quality care and had recently been able to pay for needed medical services and medications. This figure represents a decline from 56% in 2021 and 61% in 2022.
Roughly three-quarters of U.S. adults surveyed indicated that healthcare costs were a significant financial burden on their families. Conversely, only about 3 in 10 stated that these costs were not a burden.
Looking ahead, approximately half of respondents expressed extreme concern or concern about their household's ability to pay for necessary healthcare services in 2026, an increase from 42% who reported similar concerns in 2022.
The cost of healthcare contributes significantly to daily stress for more than half of the survey participants. In contrast, about 3 in 10 reported experiencing very little stress from healthcare costs, and about 2 in 10 reported no stress at all.
Several demographic groups experienced notable drops in healthcare affordability and access in 2025. Among Americans under 30, only about one-third were categorized as "cost secure," a decrease from 46% in 2021. Women, who were already less likely than men to be "cost secure," saw the gap widen. In the 2025 survey, 42% of women were "cost secure," compared to 57% of men (down from 67% in 2022).
Older Americans, predominantly covered by Medicare, generally have higher rates of being "cost secure." However, this group also saw a significant decrease, falling from 73% in 2021 to 61% in 2025.
Many survey respondents shared instances of making sacrifices to cover healthcare expenses. About 2 in 10 adults reported being unable to pay for prescribed medications in the three months prior to the survey due to costs. Furthermore, approximately 3 in 10 indicated that they or a household member had not sought treatment for a health problem because of the expense.
The West Health-Gallup Center poll surveyed 5,660 adults between October 27 and December 22, 2025. The margin of sampling error for the overall adult population is plus or minus 2.1 percentage points.