Less than half of Americans can afford quality healthcare, Gallup finds

Less than Half of Americans Can Afford Quality Healthcare, Gallup Finds

Survey Reveals Persistent Financial Strain in Healthcare Access

Less than half of Americans can afford – A recent Gallup survey reveals that fewer than half of U.S. adults were able to manage medical costs and obtain adequate healthcare in 2025, underscoring the persistent financial challenges faced by many households. Despite economic growth and advances in medical technology, the ability to afford quality care has declined, raising questions about the sustainability of current healthcare systems. The poll, which sampled 5,660 individuals over the final quarter of the year, highlights how rising expenses and insurance premiums are pushing even higher-income families toward financial uncertainty.

Cost Security Declines from 2022 to 2025

The proportion of individuals classified as “cost secure”—those with the means to access quality care and cover routine medical expenses—dropped to 49% in 2025, representing a significant decrease from the 61% recorded in 2022 and marking the lowest point since Gallup initiated tracking of this metric in 2021. This trend reflects a growing disconnect between household incomes and the cost of healthcare services. The decline has been steady, with each year showing a worsening situation, particularly as the financial burden of medical care becomes more pronounced.

Rising Worry Over Healthcare Expenses

Americans are increasingly anxious about their ability to cover medical costs, with concerns intensifying over the past three years. Fifty-one percent of respondents indicated they are worried about paying for medical services in the coming year, while 42% expressed fear about affording prescription drugs. These figures suggest a broader trend of financial anxiety, even as the overall cost of healthcare continues to rise. The Gallup findings align with other studies showing that affordability remains a top concern for most citizens, regardless of their employment status or income level.

Affordability Challenges Across Income Levels

The affordability gap is evident across all income brackets, with even well-off households struggling to meet medical expenses. Approximately one-third of households earning between $120,000 and $179,999 annually reported difficulties in accessing quality coverage or managing routine healthcare costs. Similarly, one-fifth of those making $180,000 or more faced similar challenges. This indicates that the financial strain is not limited to lower-income groups but affects a wide range of Americans, including those who have historically been more stable in their economic situations.

Generational Disparities in Healthcare Affordability

The impact of declining affordability is particularly pronounced among younger generations. Every age group in Gallup’s data, except those aged 50 to 65, saw a reduction in the percentage of individuals able to afford healthcare compared to 2023. Adults aged 18 to 29 are the most vulnerable, with only about a third considered “cost secure.” This generational divide highlights how younger Americans are disproportionately affected by rising healthcare costs, potentially shaping their long-term financial planning and career choices.

Policy Changes and Their Impact on Enrollment

The financial strain on Americans may be even more severe than reported due to policy shifts that began in early 2026. The expiration of Affordable Care Act (ACA) tax subsidies led to a sharp rise in insurance premiums, prompting many to drop coverage. Gallup’s data, collected before these changes took full effect, suggests that the real impact of the policy adjustments could be felt more acutely in the following months. According to January data, enrollment in ACA plans fell by over 1 million people since 2025. KFF, a nonprofit health policy research organization, estimates that nearly 5 million fewer Americans will sign up for ACA plans this year. This decline underscores the urgency of finding solutions to stabilize healthcare costs and maintain access for millions. The Trump administration responded swiftly to these challenges, announcing “The Great Healthcare Plan” in January. This initiative, framed as a way to reduce health insurance premiums, aims to provide direct financial relief to families. Just a month later, the administration launched TrumpRx, a platform offering discounted prescription drugs. While these measures may alleviate some pressure, their long-term effectiveness remains to be seen.

Methodology and Sample Details

Gallup conducted its findings through a combination of web and mail surveys, targeting a diverse sample of 5,660 U.S. adults. The data was collected between October and December, capturing the final months of 2025 before the ACA tax subsidies expired. The methodology ensures a representative sample, though the timing of the survey may influence its conclusions. The poll’s results are part of a broader effort to assess public sentiment toward healthcare affordability and the overall health of the U.S. insurance market.

Broader Implications of the Trend

The survey’s findings raise important questions about the future of healthcare access in America. As medical costs continue to outpace income growth, the risk of unmet medical needs increases, particularly for low- and middle-income households. The data also highlights the role of government policies in shaping affordability, with the ACA’s subsidies serving as a critical support for many. The decline in cost security may have far-reaching effects, from delaying necessary treatments to forcing individuals into high-deductible plans. Experts warn that without intervention, the trend could exacerbate health disparities and strain the economy. The Gallup poll serves as a timely reminder of the ongoing debate over healthcare reform and the need for sustainable solutions.

Expert Analysis and Future Outlook

Health policy analysts have noted that the survey’s results reflect a deeper structural issue within the U.S. healthcare system. “The data may only capture some of the strain Americans are currently feeling,” explains a KFF researcher. “With premiums spiking and coverage shrinking, the reality is that many are making tough choices between healthcare and other essential expenses.” As the new year unfolds, the challenge of balancing healthcare costs and economic stability will remain central to policy discussions. The administration’s recent initiatives, such as TrumpRx, may offer temporary relief, but long-term affordability requires systemic changes. Gallup’s findings, combined with other economic indicators, suggest that the U.S. may be at a critical juncture in its approach to healthcare accessibility.

The poll’s insights are particularly relevant as the nation grapples with inflation, rising prescription drug prices, and the broader economic impacts of the post-pandemic era. These factors contribute to a complex landscape where even those with stable incomes find themselves in a precarious position. The survey also emphasizes the need for continued monitoring of healthcare trends, as the situation evolves with each passing year.

Conclusion and Call to Action

While the Gallup poll captures a snapshot of current affordability challenges, it also serves as a warning for the future. The combination of declining cost security, rising concerns, and policy-driven premium increases indicates that the U.S. healthcare system is facing a multifaceted crisis. Addressing this issue will require a coordinated effort from policymakers, insurers, and healthcare providers to ensure that quality care remains accessible to all Americans, regardless of their financial status.

“The data may only capture some of the strain Americans are currently feeling,” explains a KFF researcher. “With premiums spiking and coverage shrinking, the reality is that many are making tough choices between healthcare and other essential expenses.”