Slight Majority of Americans Say They Can Afford Healthcare, Lowest Share Since 2021

Fewer than 49 percent of Americans say they can afford healthcare, the lowest share recorded since Gallup began tracking the figure in 2021. 8 million people no longer identified as “cost secure” in a single year, meaning they could no longer afford access to quality care or pay for visits and prescriptions.

Worry about future healthcare costs, including visits and prescriptions, reached an all-time high of more than 40 percent.

Gallup developed the Healthcare Affordability Index in 2021; the index is sponsored by West Health and relies on self-reported experiences from nationally representative surveys. Healthcare has become a financial burden across income levels. One in three upper-middle income households earning between $120,000 and $180,000 are not cost secure, and one in five households earning above $180,000 are not cost secure.

Young adults aged 18-29 experienced the sharpest decline, with the share identifying as cost secure falling 7 percentage points in one year. The gender gap widened as well. Between 2021 and 2024 the difference between men and women who said they could afford care stood at 9 percent; in 2025 the gap reached 15 percent, the largest on record.

3 trillion in 2024. 4 percent that year, the fastest increase since 2007, and insurance premiums increased 20 percent after the expiration of Affordable Care Act subsidies. Studies show that significant healthcare-related financial challenges can lead people to delay or defer care, resulting in worse health outcomes overall.