Imagine facing the new year with a knot of dread in your stomach, not knowing if you can afford to see a doctor when you need to. That's the reality for a record number of Americans as we head into 2026, according to a recent West Health-Gallup survey. The rising anxiety surrounding healthcare costs has reached a fever pitch, and the situation is only expected to worsen.
The survey reveals that nearly half (47%) of U.S. adults are genuinely worried about their ability to afford healthcare in the coming year. This isn't just a slight increase; it's the highest level of concern recorded since West Health and Gallup began tracking these anxieties in 2021. Think about that – almost one in two people are questioning whether they can afford to stay healthy.
And it's not just general healthcare costs causing sleepless nights. Concerns about the price of prescription drugs are also skyrocketing. From 2021 to 2025, the percentage of people worrying about medication costs jumped from 30% to a staggering 37% – another record high. It paints a grim picture of individuals potentially rationing essential medications or forgoing them altogether.
Adding insult to injury, the survey also found that the proportion of adults reporting "a lot of stress" in their daily lives due to healthcare costs has nearly doubled since 2022, leaping from 8% to 15%. That's a significant emotional toll, impacting not just physical health, but mental well-being too. Furthermore, about one in three adults admitted to delaying or outright skipping medical care in the past year simply because they couldn't afford it. This can lead to worsening conditions and more expensive treatments down the line, creating a vicious cycle.
The annual West Health-Gallup survey, conducted between June and August, gathered data from roughly 20,000 individuals across all 50 states and Washington, D.C. It delved into their healthcare experiences through a comprehensive set of 27 questions.
Healthcare has become a political battleground, and the survey highlights the very real impact of policy decisions on people's lives. Remember the government shutdown driven by Senate Democrats' efforts to extend enhanced subsidies for the Affordable Care Act (ACA)? Those subsidies, which have shielded many from double-digit premium increases, are scheduled to expire at the end of December. Republicans blocked the extension, and while the Trump administration promised to "fix Obamacare," a concrete plan is still missing.
"The survey shows health care affordability isn’t just a political debate, it’s a problem many people are experiencing now,” explains Larry Levitt, executive vice president for health policy at KFF, a nonpartisan research group. He emphasizes that Americans are struggling to keep pace with the relentless rise in healthcare costs.
But here's where it gets controversial... The survey didn't directly address the expiring ACA subsidies or the upcoming Medicaid work requirements slated to take effect in 2027. Some might argue this omission limits the scope of the findings, as these factors are likely to exacerbate affordability issues.
Timothy Lash, president of West Health, emphasizes the urgency of the situation, suggesting that the existing economic strains on families only amplify the problem, even if healthcare prices remain stable. He points out that every metric in the survey has either remained unchanged or worsened, indicating a consistent downward trend.
Lash sums it up poignantly: “Americans are saying, ‘Hey, now that I really think about it, I’m paying too much and I’m not getting enough.’ Health care is not what it needs to be right now.”
The survey also revealed significant variations in healthcare experiences across different states. Iowa, Massachusetts, Washington, D.C., and Rhode Island emerged as top performers, excelling in affordability, accessibility, and timely access to care. On the other end of the spectrum, Texas, New Mexico, Nevada, and Alaska faced the most significant challenges.
While 66% of people in Nebraska reported ease of access to necessary healthcare, only 30% in New Mexico and 31% in Nevada shared that sentiment.
And this is the part most people miss... Even in the highest-ranked states, affordability remains a hurdle for many. Approximately 15% of people in the top 10 states reported struggling to afford prescription drugs in the past three months, compared to a concerning 29% in the bottom 10. Similarly, about 25% in the top 10 skipped recommended tests or procedures due to cost, compared to a staggering 40% in the bottom 10.
Skipping or forgoing medical care was particularly prevalent in states like Texas (43%), Montana (43%), and Alaska (41%).
Beyond financial constraints, the survey identified other barriers to care, with 55% of respondents citing long wait times and 27% pointing to work schedules as obstacles. Interestingly, the top and bottom 10 states showed similar proportions of people delaying or preventing care due to a lack of knowledge about finding providers: 25% and 31%, respectively.
Lash cautions against declaring a clear winner among the states, emphasizing that even the top performers face significant challenges. He uses the analogy of being the tallest kid in kindergarten, only to realize that outside the classroom, the standard of comparison changes drastically.
Dr. Adam Gaffney, a critical care physician and assistant professor at Harvard Medical School, argues that the U.S. healthcare system is intentionally designed to make patients bear a significant financial burden.
Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University, suggests that the survey findings may intensify pressure on Congress to extend the ACA subsidies before year's end. Even without the subsidy extension, the implementation of Medicaid work requirements in 2027, projected to cause 4.8 million people to lose coverage according to the Congressional Budget Office, could further exacerbate the crisis.
“The public has major anxiety about access to affordable health care,” Gostin concludes. “Deep concern and anxiety over health insurance premiums and medical bills is only likely to become more acute due to the lapse in ACA premium subsidies and major cuts to Medicaid.”
This survey paints a sobering picture of the anxieties surrounding healthcare affordability in the United States. The rising costs of prescription drugs, coupled with the stress of managing medical expenses, are forcing many to make difficult choices, potentially jeopardizing their health and well-being. As we approach 2026, the need for comprehensive and sustainable solutions to address this growing crisis is more urgent than ever.
What are your thoughts on these findings? Do you think the government is doing enough to address healthcare affordability? What solutions would you propose to alleviate the financial burden on individuals and families? Share your opinions and experiences in the comments below – let's start a conversation about this critical issue.
