Healthcare Insecurity Grows
Gallup Report Shows Fewer Than Half of Americans Secure in Health Care
For the first time ever, fewer than half of Americans can reliably get and pay for health care. A new report from Gallup and West Health found that just 49% of U.S. adults are now "cost secure" — meaning they can consistently afford care and medicine. That is down sharply from 61% in 2022, a four-year drop that researchers are calling a historic turning point.
The majority — 51% — now fall into the "cost insecure" or "cost desperate" categories. "Cost desperate" Americans regularly skip prescriptions and cannot pay for basic care. Simon Haeder, an associate professor of public health at Ohio State University, called the findings a "striking marker" amid growing alarm over the state of American health care.
How America's Health Care Security Collapsed Since 2022
The 2022 peak of 61% cost-secure adults was fueled by pandemic-era protections. COVID subsidies kept premiums low. A federal rule froze Medicaid disenrollments, keeping millions covered. Then those shields came down. Starting in April 2023, states began removing people from Medicaid. Gallup reported a drop to 55% by January 2024. By mid-2026, the number hit 49% — below the majority threshold for the first time in the index's history.
Inflation in medical services has outpaced general price increases, according to the Bureau of Labor Statistics. Hospitals passed rising labor and supply costs on to private insurers. Those insurers passed them on to patients through higher deductibles and premiums. The result: even people with employer-sponsored insurance are now struggling to afford care.
Even $180,000 Salaries No Longer Buy Health Care Security
One of the most alarming findings: one in three households earning over $180,000 per year are now "cost insecure" or "cost desperate." That is a 12-point increase since 2022, according to the West Health-Gallup index. High earners were once considered safe from medical financial stress. That assumption no longer holds.
Haeder said the data reveals something fundamental. "We are seeing the erosion of the idea that a good job and a high salary can protect you from the failings of the American health care system," he said. Hospital mergers between 2023 and 2025 reduced competition in 40% of U.S. markets, driving up procedure costs even for the well-insured, according to federal antitrust analysis.
Young Adults Hit Hardest, with 58% Lacking Cost Security
Adults aged 18 to 29 are the least secure of any age group. About 58% of them fall into the insecure or desperate categories. Many work entry-level jobs with weak insurance plans and carry high student debt. That combination leaves little room to absorb a medical bill or fill a costly prescription.
Roughly one in three Americans — around 80 to 90 million people — say they or a family member delayed treatment for a serious condition in the past year because of cost, according to West Health. Skipping care today tends to produce more expensive and dangerous health crises later. Experts warn this creates a cycle that pushes insurance premiums higher for everyone.
A Three-Way Blame Game with No Easy Fix
Insurers, hospitals, and drug makers each point fingers at the others. The insurance industry blames "skyrocketing provider costs and pharmaceutical greed," citing the high price of new GLP-1 weight-loss drugs. Hospital groups say they are underfunded by Medicare and Medicaid, forcing them to charge private patients more. Drug companies say they fund innovation that saves lives.
Financial analysts at Moody's warn that if 51% of the population is cost insecure, households will divert more money to medical debt and cut back on everyday spending, according to Bloomberg. Medical debt is already the leading cause of personal bankruptcy in the U.S. With the 2026 midterms approaching, this data is expected to make health care the top voter issue — and could force Congress to revisit insurance price limits.
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