Overview
- The West Health–Gallup Affordability Index shows just 49% of U.S. adults were “cost secure” in the latest update based on a national survey fielded Oct. 27–Dec. 22, 2025.
- Gallup classified 41% of adults as “cost insecure” and 10% as “cost desperate,” and estimated 2.8 million people left the cost‑secure group between 2024 and 2025.
- Young adults, women, Black and Hispanic adults saw the steepest drops in security with 18–29 year‑olds’ cost‑secure share falling from 46% to 32% since 2021.
- The Gallup data were collected before enhanced Affordable Care Act premium tax credits expired, and experts say later 2026 premium spikes and enrollment declines mean the situation has probably worsened.
- Rising costs are already causing people to skip prescriptions and delay care, and analysts point to restoring subsidies, stronger network and price rules, and drug‑pricing changes as policy options to reverse the trend.