How many Americans can afford high-quality health care? A new poll finds the number has fallen
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- West Health-Gallup Affordability Index classified just 49% of U.S. adults as "cost secure" in 2025, down from 56% in 2021 and a peak of 61% in 2022
- The poll was conducted October–December 2025 — before Congress's Medicaid cuts and its decision not to extend Affordable Care Act subsidies took effect
- Americans under 30 saw the steepest drop, with only about one-third categorized as cost secure in 2025, down from 46% in 2021
- Women were 15 percentage points less likely to be cost secure than men in 2025 (42% vs. 57%), with the gender gap widening
- Medicare-covered older adults — historically the most cost-secure group — fell from 73% in 2021 to 61% in 2025
- About 2 in 10 respondents said someone in their household couldn't afford prescribed medicine in the prior three months, and roughly 3 in 10 skipped needed treatment due to cost
Why it matters: This is the pre-shock baseline: the poll was taken before Medicaid cuts and the ACA subsidy expiration — two cost increases that hit Americans only after the data was collected. Cost security dropped across every major demographic, including Medicare enrollees (73% to 61%), leaving no large group insulated, and half of respondents now say they're concerned about affording care in 2026.
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