A recently released national poll suggests that less than half of Americans can consistently afford healthcare.
The latest data released by the West Health-Gallup Affordability Index—a collaboration between the same-named healthcare policy nonprofit and analytics firm—classifies 49% of American adults as “Cost Secure,” or “able to access quality, affordable care and have recently been able to pay for both needed care and medicine.” This is down two percentage points from 2024 and down 12 percentage points from 2022, marking an extension of the downward trend of recent years.
Forty-one percent of adults in 2025 are considered “Cost Insecure,” or “lack access to quality, affordable care, or have recently been unable to pay for either needed care or medicine.”
Meanwhile, 10% of adults are considered “Cost Desperate,” or “lack access to quality, affordable care and have recently been unable to pay for both needed care and medicine.”
The Affordability Index study took place from October through December 2025. It polled a nationally representative sample of 5,660 adults aged 18 and older via web and mail surveys.
The analysis also noted differences in cost security across demographic lines, such as race, class, gender, age and ability.
Notably, the gap in cost security between Black and Hispanic adults as compared to white adults has consistently widened since 2021. Cost security has declined by 16 percentage points and 19 percentage points among Black and Hispanic adults respectively, while it has declined by three percentage points among white adults.
Healthcare affordability also remains problematic across income levels, with substantial populations of adults considered middle income ($48,000 to $119,999 annual income) or upper middle income ($120,000 to $179,999) classed as cost insecure or desperate. The share of such adults from these income classes has increased from 2024 to 2025, and “about a third of U.S. households with incomes between $120,000 and $179,999 per year are not 'cost secure',” according to the report.
The age demographic that experienced the sharpest decline in healthcare affordability from 2021 to 2025 is adults aged 18 to 29, with a drop from 46% cost secure to 32%.
Although adults aged 65 and over remain most likely to be cost secure due to Medicare, there have been meaningful declines in cost security among this group as well, with percentages falling from 73% in 2021 to 61% in 2025.
The West Health-Gallup Poll also said that: “On average, Americans with chronic conditions are significantly less likely to be cost secure than those without any chronic conditions, and for certain diagnoses, the gap is substantial.” For example, only34% of adults with Chronic Obstructive Pulmonary Disease (COPD) are cost secure, which reflects the lack of healthcare affordability for adults with conditions that require ongoing medical care.
Adults with mental health conditions are also less likely to be cost secure, with more than six in 10 adults with anxiety and depression struggling to pay for healthcare services and prescriptions. Gallup also said this affordability gap may impact these adults’ ability to manage their conditions.
A gap between women and men in healthcare cost security has existed since 2021, but in 2025, it has widened to a high of 15 percentage points. This significant gender gap is due to the steep divergence from 2024 to 2025, with the percentage of women classed as cost secure falling from 48% to 42% while the percentage of men increased from 55% to 57%.
In line with previously shared data, U.S. adults’ concern about the ability to afford healthcare has reached the highest level since tracking began in 2021. Concerns about affording prescription drugs and needed healthcare service has increased by 12% and 9%, respectively, from 2021 to 2025.
"Amid an increasingly challenging economic environment, this steady erosion of healthcare affordability in recent years suggests that rising costs are continually outpacing households’ ability to pay,” the report reads. Healthcare spending had risen by 7.2% in 2024, while healthcare prices rose by 3.4% in 2024, it notes.
"Taken together, declining cost security and rising concern about future affordability point to healthcare as a serious and significant financial challenge facing Americans in 2026. If left unaddressed, these trends risk contributing to delayed care, poorer health outcomes, increased medical debt, greater health system burden, and, by extension, even more cost," the report concludes.