What Happens When Healthcare Costs Are Out of Reach?

In the infographic below, we illustrate how Americans fall into three categories of healthcare affordability. Each of these categories—or paths—leads to dramatically different outcomes for access to care, financial stability, and overall well-being.

Key Takeaways:

· A shrinking share of Americans are Cost Secure. Roughly half of U.S. adults (49%) can obtain the healthcare and medicine they need without running into cost barriers, down 12 percentage points from 2022.

· Another 41% fall into the Cost Insecure category, meaning they have either struggled recently to pay for prescriptions or treatment, or they don't have reliable access to affordable, quality care.

· At the other end of the spectrum, an estimated 27.1 million U.S. adults (10%) are Cost Desperate, meaning they've recently gone without needed care, couldn't afford prescribed medicine, and don't believe they could pay for quality care if they needed it today. That's a 3-point rise over 2022.

Being Cost Desperate carries real costs. These adults are far more likely than Cost Secure adults to trade off healthcare against essentials like food and utilities, to know someone who passed away after going without care they couldn't afford, and to worry they won't be able to pay for their own medicines and treatments going forward.

About the Data:

• Since 2021, West Health and Gallup have tracked healthcare affordability, access, quality and value through ongoing surveys of at least 3,000 Americans per survey administration.

• The findings are informed by the West Health-Gallup Healthcare Affordability Index, which evaluates three key factors in determining Americans’ ability to afford healthcare:

  • Care avoidance: Has there been a time in the last three months when you or a member of your household had a health problem, but you did not seek treatment due to the cost of care?

  • Skipped treatments: Has there been a time in the last three months when you or a member of your household has been unable to pay for medicine or drugs that a doctor had prescribed for you because you did not have enough money to pay for them?

  • Difficulty today: If you needed access to quality healthcare today, would you be able to afford it?

• Based on their responses, Americans fall into one of three categories:

  • Cost Secure: Individuals say they have access to quality, affordable care and have recently been able to pay for both needed care and medicine.

  • Cost Insecure: Individuals say they lack access to quality, affordable care or have recently been unable to pay for either needed care or medicine.

  • Cost Desperate: Individuals say they lack access to quality, affordable care and have recently been unable to pay for both needed care and medicine.

Sources

West Health – Gallup Healthcare Affordability Index 2026 Article: U.S. Adults' Ability to Afford Healthcare at a Five-Year Low

West Health - Gallup Center on Healthcare in America