Overview
- A nationally and state-representative West Health–Gallup survey of 19,535 adults conducted June–August 2025 found 33% made at least one trade-off in the past year to pay for care, equivalent to more than 82 million people.
- The most common actions were prescription rationing or non-adherence and borrowing money (15% each), followed by skipping meals (11%), driving less (11%) and cutting back on utilities (9%).
- Financial strain was most severe for the uninsured (62%) and households earning under $24,000 (55%), yet it also reached higher earners, including 25% of those at $90,000–$120,000 and 11% at $240,000 or more.
- A separate Gallup panel survey from October–December 2025 reported widespread postponement of life events due to health costs, including surgical or medical treatment (26%), job changes (18%), home purchases (14%), retirement (9%) and having or adopting a child (6%).
- Analysts and multiple reports tie worsening affordability to the expiration of enhanced ACA premium subsidies and recent Medicaid policy changes, with higher premiums and out-of-pocket costs now a prominent election issue.