Fewer than half of Americans were able to afford medical bills and obtain quality care last year, according to a new Gallup poll that points to growing financial pressure, including for many higher-earning families.
Gallup found that the share of Americans it classifies as “cost secure” — people who can access quality healthcare while also covering doctor visits and prescription costs — dropped to 49% last year. That is down from a high of 61% in 2022 and represents the lowest reading since Gallup started measuring the figure in 2021.
At the same time, anxiety over healthcare expenses is rising. In Gallup’s survey, 51% of respondents said they are worried about paying for medical care over the next year, while 42% said they are concerned about being able to afford prescription medications.
The problem is not limited to lower-income households. Gallup found that roughly one-third of households earning between $120,000 and $179,999 annually, along with one in five households making at least $180,000, said they either did not have quality coverage or had trouble paying for costs such as prescription drugs.
Generational differences also emerged, but affordability weakened across nearly every age group. Gallup’s data shows that from 2023 to 2025, every age bracket except adults ages 50 to 65 saw a decline in the share of people able to afford healthcare. Young adults ages 18 to 29 were hit hardest, with only about one-third falling into the cost-secure category.
The findings may understate the pressure many Americans now face, since the survey was completed before Affordable Care Act tax subsidies expired in early 2026. That change drove premiums higher and led some people to drop their insurance coverage.
Data from January shows ACA enrollment dipped by more than 1 million from 2025. KFF, a nonprofit provider of health policy news and research, estimates that nearly 5 million fewer people will enroll in ACA plans this year.
In January, the Trump administration announced “The Great Healthcare Plan,” which the White House said would lower health insurance premiums and deliver money directly to Americans to cover healthcare costs. A month later, the administration launched TrumpRx, a site where Americans can get drugs at discounted prices.
Gallup based the findings on web and mail surveys of 5,660 U.S. adults conducted between October and December.
