Fewer than half of American adults now say they can consistently pay for health care, according to the West Health-Gallup affordability index. Another 41% are 'cost insecure,' unable to afford medicine or routine visits.
The expiration of enhanced Affordable Care Act subsidies is a key driver. Stacy Cox of Utah saw her monthly premium surge from $500 to over $2,100. She and her husband, self-employed audio engineer John Crowley, dropped their ACA plan for a short-term policy with a $10,000 deductible.
Even insured, the couple now skips recommended tests. An MRI for Crowley’s leg pain cost $399 at a center 90 minutes away-far less than the $2,200 a local health system quoted, which would not count toward their deductible if they paid cash.
'We have a very good life,' Cox said. 'Every month, we come back to the table to say, "Have we reached the pain point yet?" It’s all because of health care.'
Employer-sponsored insurance costs are also climbing, with companies expecting to spend an average $18,500 per employee in 2026, up 6.7%. The squeeze is forcing more Americans to delay care or face financial strain.