Healthcare affordability has become a growing national pressure point as insurance premiums, out-of-pocket costs and prescription expenses continue to strain household budgets. New data released June 18 by the West Health-Gallup Center on Healthcare in America shows that concern has now reached a record level nationwide. The findings point to a broad erosion in how secure Americans feel about paying for their own care, even among many households above the lowest income brackets.
West Health-Gallup reports a record level of healthcare cost anxiety
The West Health-Gallup Center on Healthcare in America reported on June 18 that 51% of U.S. adults are worried they will not be able to afford necessary healthcare in the coming year, up from 42% in 2021. In the same release, the organizations said just 49% of adults are now classified as “Cost Secure,” meaning they can afford access to quality care and have recently been able to pay for healthcare visits and prescription medicines. West Health said that is the lowest level recorded since the Healthcare Affordability Index launched in 2021.
Gallup said the measure is based on its latest West Health-Gallup Affordability Index, which tracks whether adults can consistently pay for care when needed. The survey also found concern about paying for prescription drugs rose to 42% from 30% between 2021 and 2025. The organizations described the combined findings as evidence of a deepening affordability problem affecting both access to care and confidence about future costs.
The June release adds to a series of recent findings showing healthcare costs are influencing broader financial decisions. In March, West Health and Gallup reported that about one in three U.S. adults had made at least one daily life trade-off in the previous year to cover healthcare expenses. Those trade-offs included cutting back on food, utilities or other household spending, according to the survey summary.
The June 18 affordability release described the problem as national in scope and did not identify one single state as driving the increase. West Health and Gallup said the results are based on a nationally representative sample of U.S. adults, weighted to reflect the country’s population. That means the headline figure applies across the United States, but the release did not provide a fresh state-by-state breakout tied specifically to the new 51% concern level.
What is confirmed is that affordability pressures extend across age, income and health-status groups. West Health said cost security among adults age 65 and older fell from 73% in 2021 to 61% in 2025, despite the broad coverage many seniors receive through Medicare. The survey also found especially low cost security among people reporting chronic or serious health conditions, including COPD, compromised immune systems, anxiety and depression.
Earlier West Health-Gallup state research, published in November 2025, found major differences in how Americans experience healthcare depending on where they live. But the organizations have not released a comprehensive new state list attached to the June 2026 affordability report. That leaves the national trend clear while some local variation remains unquantified in the latest release.
West Health and Gallup tied the new findings to a longer-term decline in perceived healthcare affordability rather than to one isolated event. Their June analysis said concern about paying for needed services and prescriptions has climbed steadily since 2021. The decline in “Cost Secure” households also suggests the issue is not limited to uninsured adults or people at the lowest income levels.
Gallup reported that substantial shares of middle-income and upper-middle-income households were not cost secure in 2025, and that those shares increased from the prior year. Separate Urban Institute research published in June found 46% of working-age adults reported family difficulties affording healthcare in December 2025, reinforcing the picture of widespread strain. Recent Gallup and West Health reporting has also found people delaying care, borrowing money or making other financial sacrifices to manage medical bills.
For households, the practical meaning is straightforward: more Americans say healthcare costs are affecting whether they feel financially stable, even before a medical emergency occurs. West Health said the trend points to healthcare as a serious financial challenge in 2026, while Gallup described Americans’ ability to afford care as sitting at a five-year low. The latest figures do not forecast when that pressure may ease, but they document that affordability concerns are now more widespread than at any point since this tracking began.