Inflation is no longer Americans’ No. 1 concern. Nowadays, it’s the price of health care that’s making Americans sweat. 

Health care costs are the top concern among middle-income American households for the first time since 2021, outpacing inflation, according to a national survey from financial service provider Primerica. While more than half of survey respondents said that they remain pessimistic about the economy as a whole, 20% expressed being “slightly more optimistic” about their personal finances compared with just 15% of respondents in the previous quarter. 

“As the nation heads further into 2023, middle-income Americans are showing increasing confidence in their personal finances while remaining realistic about the current economic climate,” Primerica CEO Glenn J. Williams said in a press release. 

Primerica’s “Middle-Income Financial Security Monitor” collects data from American households with annual incomes between $30,000 and $100,000 on a quarterly basis. The national poll, conducted by research firm Change Research, surveyed 1,471 respondents about their households’ financial health between March 6 and 10.

Ongoing stressor 

Health care expenses haven’t always topped the list of concerns facing American households, but they have long been a stressor for many families struggling to manage their finances. 

Roughly 40% of adults report going into debt due to medical or dental bills, according to polling data from the Kaiser Family Foundation, a nonprofit focused on health policy research. Additionally, roughly half of Americans say they struggle to afford health care costs, the survey shows. 

“It’s like you are unprepared no matter how prepared you are,” said Ally Ward from Chicago. She and her husband, Marcus, previously spoke with CBS News Consumer Investigative Correspondent Anna Werner in partnership with KFF Health News, about the medical debt that continues to follow them.

The high cost of medical care has a disproportionate impact on people of color, as well as women, low earners and uninsured adults. Still, even those covered by health insurance “are not immune to the burden of health care costs,” according to the KFF analysis.

Approximately one-third of insured adults worry about paying their monthly health insurance premium, and 44% worry about affording their deductible, the survey found.

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About four in 10 U.S. adults surveyed said they have either delayed or gone without medical attention all together in the last year because they could not afford it. Out of all types of health care, according to the poll, adults reported putting off dental service the most due to cost.

Inflation still high on the list

Even though inflation isn’t the top-ranked concern, it’s still high on the list of worries for many Americans, Primerica found. 

Roughly one-fifth of respondents expressed fears that the U.S. would enter a recession. Meanwhile, 40% of households surveyed reported spending less money than a year ago, up from 32% the previous quarter, according to the survey.  

In addition, more than one-third of respondents reported that they’ve used their credit cards more frequently during the past year, with roughly half saying they’ve used their credit cards for everyday purchases, including gas and groceries.

Consumer credit card debt hit a record high of $4.82 trillion in February, according to a new report from the Federal Reserve, as rising interest rates and ongoing inflation continue to eat into household budgets.

Silver linings

Despite more respondents reporting usage of credit cards to pay for basic necessities, the number of households in debt is decreasing, survey data shows.

According to the survey, 33% of households reported their credit card debt increasing in the past three months, down 4% from the portion who reported an increase in the previous quarter. In addition, the number of households without any credit card debt increased from December to roughly a quarter of respondents. 

Said Williams: “The Financial Security Monitor found that the middle market’s reliance on credit cards may be slowing, and families are taking positive steps to pay down consumer debt.”