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1 in 2 Americans Now Fears They Can't Afford Health Care

Infographic showing US healthcare affordability in 2026 — cost secure rate fell from 61% (2022) to 49% (2026), 51% worry about affording care next year, prescription cost worry rose from 30% (2021) to 42% (2025)

Last updated: August 28, 2026

[Key Takeaways]

  • Only 49% of US adults now describe themselves as "cost secure" for health care, a 12-percentage-point drop from 2022 and the lowest level recorded in five years of tracking.
  • 51% of adults say they are worried about being able to afford needed care over the next 12 months, the highest share recorded since this tracking began in 2021.
  • Concern about affording prescription drugs rose from 30% in 2021 to 42% in 2025.
  • A separate December survey found 23% of adults describe the US healthcare system as "in crisis" (a record high) and 47% say it has "major problems."
  • Practical approaches such as generic medications, prescription discount cards, hospital financial assistance programs, and community health centers may help offset rising costs.
This article is intended for general informational purposes and is not a substitute for professional medical advice, diagnosis, or treatment. Please consult a licensed healthcare professional regarding your own health situation.

It is written in the hope that it can be of even a little help to many readers.

Overview

Healthcare affordability has become one of the most closely watched indicators of financial well-being in the United States, and new survey data suggest the picture is worsening. According to long-running Gallup-West Health tracking, the share of US adults who feel confident they could afford the health care they need has fallen to its lowest point in five years. At the same time, a separate national survey conducted in December found that a growing number of Americans view the healthcare system itself as being in a state of crisis. This article walks through what the 2026 data show, why prescription drug costs are drawing particular concern, and some practical, non-prescriptive steps people can consider if they are worried about their own healthcare bills.

What the 2026 Gallup-West Health Survey Found About Healthcare Costs

Gallup and West Health have tracked how confident US adults feel about affording health care on an annual basis since 2021. Their surveys ask respondents whether they believe they could afford quality health care if they needed it, without experiencing serious financial hardship. Adults who answer affirmatively are classified as "cost secure," while those who express doubt fall into a "cost insecure" category. The 2026 wave of this tracking shows a notable shift in both measures.

Cost Secure Rate Falls to 49%, a 5-Year Low

In 2026, only 49% of US adults reported feeling cost secure about their health care[1][2], down from roughly 61% in 2022[1][2] — a 12-percentage-point decline. This is the lowest cost secure rate recorded since Gallup and West Health began this specific tracking effort five years ago.[1][2] The decline has not been limited to any single demographic group; survey summaries describe the drop as broad-based across income levels and age groups, with one notable exception: adults aged 50 to 64 were the only age group that did not see a decline,[1][2] suggesting that cost concerns extend well beyond lower-income households that have historically reported the highest levels of financial strain related to health care.

[1] Gallup, "U.S. Adults' Ability to Afford Healthcare at a Five-Year Low" (2026)
[2] West Health, "Americans' Ability to Afford Healthcare Falls to Five-Year Low" (2026)

51% Worry They Can't Afford Needed Care Next Year

Alongside the drop in cost security, the same June 2026 Cost Secure Index release found that 51% of adults are worried about not being able to afford care they might need over the next 12 months[1][2], the highest share recorded since this question was first tracked in 2021.[1][2] "Needed care" in this context can cover a range of situations — a routine doctor visit, a recommended screening or procedure, ongoing management of a chronic condition, or a prescription medication. When affordability worries are high, some adults may delay scheduling appointments or postpone recommended treatment until costs feel more manageable, which can create its own set of downstream concerns for long-term health management.

[1] Gallup, "U.S. Adults' Ability to Afford Healthcare at a Five-Year Low" (2026)
[2] West Health, "Americans' Ability to Afford Healthcare Falls to Five-Year Low" (2026)

Prescription Drug Costs: A Growing Worry for US Adults

Prescription medication costs have emerged as a specific driver of overall healthcare affordability concerns. Survey tracking from the same June 2026 Cost Secure Index release shows that the share of adults who say they are worried about affording prescription drugs rose from 30% in 2021 to 42% in 2025,[1][2] a steady increase over four years rather than a single sharp jump. This upward trend has occurred even as overall healthcare cost concerns were already elevated.

[1] Gallup, "U.S. Adults' Ability to Afford Healthcare at a Five-Year Low" (2026)
[2] West Health, "Americans' Ability to Afford Healthcare Falls to Five-Year Low" (2026)

Prescription drug affordability concerns tend to weigh most heavily on adults managing chronic health conditions, largely because of how these conditions are typically treated over time. Unlike a short course of antibiotics or a one-time procedure, chronic disease management often involves taking one or more medications every day, sometimes for years or for the rest of a person's life. This ongoing need means that even modest per-prescription costs can accumulate substantially over the course of a year, and patients taking multiple medications may face compounding co-payments, deductibles, or coverage gaps depending on how their insurance plan is structured. Specialty medications and certain brand-name drugs without an available generic alternative can add further financial pressure, since these products are sometimes placed in higher cost-sharing tiers under many insurance formularies. As a result, the day-to-day, cumulative nature of chronic disease treatment can make prescription costs feel especially burdensome compared with occasional, short-term healthcare expenses.

For the millions of Americans managing chronic conditions such as type 2 diabetes, high blood pressure, or elevated cholesterol, ongoing out-of-pocket prescription costs may affect medication adherence[1][2] — meaning some individuals could be more likely to skip doses, split pills, or delay refills when a prescription feels financially out of reach. This is not a certainty for every patient, and the relationship between cost concern and actual medication-taking behavior can vary by individual circumstances, insurance coverage, and the specific medication involved. Anyone who is rationing or skipping a prescribed medication for cost reasons is encouraged to talk to their prescribing clinician or pharmacist, since lower-cost alternatives or assistance programs may be available for specific drugs.

[1] Fusco et al., J Manag Care Spec Pharm (2023)
[2] Holbrook et al., Systematic Reviews (2021)

Is the US Healthcare System "In Crisis"? A Separate December Survey

It is worth distinguishing the Gallup-West Health cost-security tracking discussed above from a separate national survey conducted in December, which asked adults for their broader assessment of the US healthcare system rather than their personal ability to pay for care. This December survey found that 23% of US adults describe the healthcare system as being "in crisis,"[1] the highest share recorded since this particular survey question has been asked. An additional 47% said the system has "major problems,"[1] short of a full crisis but far from functioning well. Combined, roughly seven in ten respondents characterized the system as either in crisis or facing major problems.

[1] Gupta, Washington Post (2025)

This December survey drew notable media coverage of its own, with the Washington Post reporting on the findings on December 15, 2025.[1] That coverage is separate from the media attention given to the Gallup-West Health Cost Secure Index data discussed earlier in this article: when the June 2026 Cost Secure Index findings were released, CBS News, U.S. News & World Report, and FierceHealthcare each published coverage of those results within a similar window, around June 18 through 23, 2026.[2][3][4] In other words, two distinct surveys — the December "crisis" survey and the June Cost Secure Index — received attention from two different groups of outlets at two different points in the year. The overlapping public attention to both stories reflected how the December results landed alongside — and reinforced — the cost-security concerns already documented by Gallup and West Health, even though the two survey efforts are conducted independently, use different methodologies, and were fielded at different times of year. Readers should treat them as two related but distinct data points rather than a single combined study.

[1] Gupta, Washington Post (2025)
[2] CBS News (2026)
[3] U.S. News & World Report (2026)
[4] FierceHealthcare (2026)

Concerns of this magnitude may not stay confined to survey responses. Some public health researchers and policy analysts have suggested that persistent worry about the state of the healthcare system, combined with the affordability pressures described above, could influence how and when people seek care. Possible behavioral responses discussed in this context include postponing routine checkups or recommended screenings, delaying a visit to a primary care provider until a condition becomes more serious, or attempting to manage symptoms at home rather than visiting an emergency department. These are potential patterns rather than confirmed outcomes for any individual, and further research would be needed to establish how closely survey-based attitudes translate into actual changes in care-seeking behavior. Even so, anyone experiencing symptoms that feel severe or are rapidly worsening is encouraged to seek prompt medical evaluation rather than delay care based on cost concerns alone, since many hospitals offer financial assistance programs intended for exactly this kind of situation.

Practical Ways to Manage Rising Healthcare and Prescription Costs

While the survey data reflect a genuinely difficult affordability environment, there are several general, widely available approaches that may help reduce out-of-pocket healthcare and prescription costs. None of these options will be a fit for every situation, and talking with a healthcare provider, pharmacist, or hospital financial counselor about which options apply to a specific case is a reasonable first step.

  • Ask about generic equivalents. Generic medications typically contain the same active ingredient as their brand-name counterparts and may cost significantly less.[1] Pharmacists and prescribing clinicians can often say whether a generic version of a prescribed drug is available. For example, a helpful question to bring to a pharmacy visit might be, "Is there a generic version of this medication, and would it work the same way for my prescription?" or "Are there other medications in the same drug class that treat my condition at a lower cost?"
  • Look into prescription discount cards and manufacturer assistance programs. A number of independent discount card programs and pharmaceutical manufacturer assistance programs exist that may lower the price paid at the pharmacy counter for certain medications, though eligibility and savings vary by drug and program.
  • Ask hospitals about financial assistance (charity care) programs. Many nonprofit hospitals are required to offer some form of financial assistance to patients who meet income-based eligibility criteria, which can reduce or, in some cases, eliminate billed amounts for care already received.[2]
  • Consider community health centers. Federally qualified community health centers commonly offer services on a sliding-scale fee basis tied to household income, which may make routine and preventive care more accessible regardless of insurance status.[3]
  • Review insurance plan options during open enrollment. Comparing available plans each year — rather than automatically renewing the same coverage — may reveal options with lower premiums, deductibles, or prescription drug costs that better match current healthcare needs.

[1] FDA, "Generic Drugs: Questions & Answers"
[2] IRS, "Requirements for 501(c)(3) Hospitals — Section 501(r)"
[3] HRSA Bureau of Primary Health Care, "Sliding Fee Discount Program"

These approaches are not mutually exclusive, and the right starting point often depends on the type of cost concern involved. Generic substitutions and discount cards tend to be most useful for addressing an immediate, recurring prescription expense, while hospital financial assistance programs and community health centers are generally better suited to larger one-time bills or ongoing primary care needs for someone without adequate insurance coverage. Reviewing insurance options is typically most effective when approached proactively, during the annual open enrollment period, rather than after a costly bill has already been incurred.

Anyone facing an immediate affordability barrier to a medication or treatment is encouraged to speak directly with their healthcare provider or a hospital financial counselor about options, since specific programs and eligibility rules can change and vary by state, insurer, and provider.

References

  1. Gallup. "U.S. Adults' Ability to Afford Healthcare at a Five-Year Low." Poll 710942 (June 18, 2026). https://news.gallup.com/poll/710942/adults-ability-afford-healthcare-five-year-low.aspx
  2. West Health. "Americans' Ability to Afford Healthcare Falls to Five-Year Low." (June 2026). https://westhealth.org/news/americans-ability-to-afford-healthcare-falls-to-five-year-low/
  3. Gupta G. "Nearly one-quarter of Americans say the health care system is in crisis." Washington Post (December 15, 2025). https://www.washingtonpost.com/nation/2025/12/15/health-care-crisis-gallup
  4. CBS News. "Less than half of Americans can afford quality healthcare, Gallup finds." (June 18, 2026). https://www.cbsnews.com/news/healthcare-costs-affordability-gallup-poll-2026/
  5. U.S. News & World Report. "Rising Healthcare Costs Leave Many Americans Less Secure." (June 22, 2026). https://www.usnews.com/news/health-news/articles/2026-06-22/rising-healthcare-costs-leave-many-americans-less-secure
  6. FierceHealthcare. "Half of U.S. adults can't afford healthcare, Gallup poll finds." (June 23, 2026). https://www.fiercehealthcare.com/payers/gallup-poll-claims-less-50-american-adults-can-afford-healthcare
  7. Fusco N, Sils B, Graff JS, Kistler K, Ruiz K. "Cost-sharing and adherence, clinical outcomes, health care utilization, and costs: a systematic literature review." J Manag Care Spec Pharm. 2023;29(1):4-16. https://doi.org/10.18553/jmcp.2022.21270
  8. Holbrook AM, et al. "Cost-related medication nonadherence in Canada: a systematic review of prevalence, predictors, and clinical impact." Syst Rev. 2021;10:11. https://doi.org/10.1186/s13643-020-01558-5
  9. Patel S, Huang M, Miliara S. "Understanding Treatment Adherence in Chronic Diseases: Challenges, Consequences, and Strategies for Improvement." J Clin Med. 2025;14(17):6034. https://doi.org/10.3390/jcm14176034
  10. FDA. "Generic Drugs: Questions & Answers." https://www.fda.gov/drugs/generic-drugs/generic-drugs-questions-answers
  11. IRS. "Requirements for 501(c)(3) hospitals under the Affordable Care Act – Section 501(r)." https://www.irs.gov/charities-non-profits/charitable-organizations/requirements-for-501c3-hospitals-under-the-affordable-care-act-section-501r
  12. HRSA Bureau of Primary Health Care. "Chapter 9: Sliding Fee Discount Program." https://bphc.hrsa.gov/compliance/compliance-manual/chapter9
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