More than 82 million Americans — roughly one in three adults — have cut back on at least one daily necessity to cover health care costs, according to a new West Health-Gallup Center on Healthcare in America survey. Furthermore, the findings reveal a crisis that cuts across income levels, insurance status, and geography. Health care affordability is no longer just a low-income concern. It is a widespread national emergency reshaping how ordinary Americans live, work, and plan for their futures.
The Scale of America’s Health Care Affordability Crisis
The West Health-Gallup Center surveyed nearly 20,000 U.S. adults between June and August 2025. The results are striking. Approximately one-third of respondents said they made at least one financial trade-off in the past year to pay for health care or prescription medication. Based on those findings, researchers estimate that over 82 million Americans face this burden regularly.
Why Health Spending Is Rising
Health care spending continues to climb, partly because the country’s overall health is declining. When people cannot afford care, they delay treatment. Delayed treatment leads to worsening conditions. Worsening conditions lead to higher costs. This cycle drives the affordability crisis deeper with each passing year. Tim Lash, president of West Health, noted that rising expenses and declining public health reinforce each other, creating a compounding problem that policy has not yet resolved.
What Americans Are Sacrificing Every Day
The survey identified several specific trade-offs that Americans make to cover their medical bills. These sacrifices are concrete, measurable, and deeply disruptive to everyday life.
Skipping Meals and Rationing Medications
The most common trade-offs were prescription rationing and borrowing money, each reported by 15% of respondents. Additionally, 11% of Americans — equivalent to roughly 28 million people — said they skipped meals to pay for health care. Another 11% reported driving less to save money on fuel. Meanwhile, 9% cut back on utilities such as electricity and heating.
Borrowing to Stay Healthy
Borrowing money to cover medical bills reflects just how far the financial strain extends. Many Americans carry medical debt alongside credit card balances, student loans, and rising grocery bills. Health care costs have thus become one more financial pressure on households that are already stretched thin.
Who Feels the Pressure Most
While the crisis touches nearly every demographic, some groups bear a far heavier burden than others.
Uninsured Americans Face Steeper Odds
Among those without health insurance, 62% reported making at least one daily financial sacrifice to afford care. Uninsured people are also:
- 1.7 times more likely to prolong prescriptions
- 2.5 times more likely to borrow money
- 3 times more likely to skip a meal
- 2.8 times more likely to cut back on utilities
Lower-Income Families Struggle Most
More than half of Americans in households earning below $24,000 annually said they had to make financial sacrifices to afford health care. However, the pressure does not stop there. About one in four adults earning between $90,000 and $120,000 reported making similar trade-offs. Even 11% of households earning $240,000 or more said they sacrificed necessities to cover medical costs.
As Gallup researcher Ellyn Maese put it, even middle-class and upper-middle-class Americans are now choosing between medical bills and paying for utilities or driving to work.
Life Decisions Derailed by Medical Costs
Beyond daily sacrifices, a separate West Health-Gallup survey of nearly 6,000 adults found that health care costs are reshaping long-term life decisions at an alarming scale. In fact, 78% of Americans have postponed at least one major life event in recent years because of medical expenses.
Major Milestones on Hold
Specifically, the data shows:
- 26% delayed surgical or medical treatment
- 18% changed or avoided changing jobs
- 14% put off buying a new home
- 9% postponed retirement
- 6% delayed having or adopting a child
These are not minor inconveniences. Delaying retirement or forgoing medical treatment can have severe, lasting consequences for individuals and families alike.
The Road Ahead: A Crisis Set to Worsen
Experts warn the situation will likely deteriorate. Republican lawmakers approved more than $1 trillion in cuts to federal health care support last year. Additionally, enhanced Affordable Care Act premium subsidies expired at the end of 2025. As a result, millions more Americans are expected to lose insurance coverage in the coming months.
Anxiety and Mental Health Toll
Beyond physical health, the financial burden is also affecting mental well-being. Lash noted that the stress of making these daily trade-offs significantly increases anxiety and depression among affected households. Consequently, the cascade of unaffordable care damages both physical and mental health simultaneously.
A System Failure, Not a Personal Problem
The data from this survey points to a structural breakdown rather than individual financial mismanagement. As Lash stated clearly, when families across every income level must choose between paying a medical bill and keeping the lights on, that is not a budgeting problem — it is a systems failure.
Moreover, this survey aligns with other recent polls. A KFF study found that health care costs top the list of Americans’ economic anxieties. A Washington Post-ABC News-Ipsos poll similarly found that health care feels unaffordable to most respondents.
Moving Toward Solutions
West Health is working with policymakers and health system leaders to advance practical, scalable reforms. The goal is to address root causes, not just symptoms. Meanwhile, public pressure is mounting. Researchers and advocates agree that health care affordability is likely to remain a defining political and social issue in the months ahead.
