Americans are entering 2026 more concerned about health care costs than at any time in years. New West Health-Gallup Study Finds.
Nearly half of adults, 47%, say they are worried they won't be able to afford health care in the next year, the highest level since West Health and Gallup began tracking the situation in 2021, a survey released Tuesday found.
Concerns about prescription drug costs The study found that this rate has been rising steadily, from 30% in 2021 to 37% in 2025, also the highest level recorded. And the share of adults who say health care costs cause “a lot of stress” in their daily lives has nearly doubled since 2022, rising from 8% to 15%. The study also found that about one in three adults reported delaying or skipping medical care in the past year because they couldn't afford it.
The annual survey, conducted from June to August, covered approximately 20,000 respondents in all 50 states and Washington, D.C., and included 27 questions about people's experiences with health care.
Health care has become a central issue in politics. Senate Democrats push to expand expanded subsidies under the Affordable Care Act led to the longest government shutdown in history. ACA tax breaks that protected people from double-digit premium increaseExpires December 31st. Republicans blocked the effort, and the Trump administration promised “fix Obamacare” but has not yet published a detailed plan.
“The survey shows that health care affordability is not just a political debate, but an issue that many people face right now,” said Larry Levitt, executive vice president for health policy at KFF, a nonpartisan research group. “Americans are struggling to cope with rising costs of health care in general and health care in particular.” He did not participate in the survey.
The survey did not affect the subsidy expires. It also did not include questions about Medicaid Employment Requirements it will come into force in 2027.
Combined with subsequent loss of insurance coverage, many people could will face even more serious problems in paying for health care in the coming years, said Timothy Lash, president of West Health, a nonpartisan group that studies health care costs and aging.
“The urgency of this issue is real,” Lash said. “When you look at the economic strain that families are feeling right now, even if health care prices haven't gone up, costs are going up elsewhere, which only makes the problem worse.”
Lash said all survey metrics either remained the same or worsened.
“Americans are saying, 'Hey, now that I really think about it, I'm paying too much and not getting enough,'” Lash said. “Health care is not what it should be now.”
Differences between states
How people receive health care varies greatly from state to state.
Iowa, Massachusetts, Washington, D.C., and Rhode Island ranked first in their overall level of health care, especially in how easily residents can afford, access, and obtain care when and where they need it.
Texas, New Mexico, Nevada and Alaska were at the bottom of the list.
While 66% of Nebraskans, which ranked 10th overall, said it was easy to get the health care they needed, only 30% in New Mexico and 31% in Nevada agreed.
But even in the highest-ranking states, many people still face challenges, Lash said. About 15% of residents in the top 10 states said they were unable to pay for prescription drugs in the past three months, compared with 29% in the bottom 10 states.
About 25% of residents in the top 10 states reported skipping recommended lab tests or medical procedures because of cost in the past year, compared with 40% of residents in the bottom 10 states.
Skipping or refusing medical care is most common in states such as Texas (43% reported it), Montana (43%) and Alaska (41%), the study found.
In addition to cost, Americans cited other barriers limiting access to health care. Nationally, 55% said long wait times prevent or delay care, and 27% cited work schedules as a barrier.
The top 10 and bottom 10 states had similar proportions of people who delayed or prevented care because they didn't know how to find providers: 25% and 31%, respectively.
“When you look at the ratings … we have to be very careful to say that anyone has won,” Lash said. “It’s like being the tallest kid in kindergarten and then suddenly walking out of class and realizing that maybe you’re not that tall after all.”
Dr. Adam Gaffney, a critical care physician and assistant professor at Harvard Medical School, said the U.S. health care system is designed to keep patients “in the game” when it comes to paying high health care costs.
“While it is not surprising that states with high uninsurance rates, such as Mississippi, which did not expand Medicaid, have higher levels of cost concerns than a state like Massachusetts, where I work,” Gaffney wrote in an email, “even here in the Bay State, large numbers of people experience cost concerns due to inadequate insurance.”
Lawrence Gostin, director of the O'Neill Institute for National and Global Health Law at Georgetown University, said the findings could put pressure on Congress to extend the law. expanded ACA subsidies until the end of the year.
Even if they don't, he said, the pressure could increase once Medicaid work requirements begin in 2027. Congressional Budget Office, a nonpartisan government group, projects that 4.8 million people will lose coverage due to work requirements.
“The public has significant concerns about access to affordable health care,” Gostin said. “Deep concern and anxiety about health insurance premiums and bills will likely become even more acute with the end of ACA subsidies and significant cuts to Medicaid.”
