Twanetta Weaver thought she was making a smart decision when she signed up for a high-deductible health insurance plan through her job. It was supposed to help her avoid steep premiums and even save a bit for retirement.
However, in 2025, everything changed when she slipped a disc in her back, leading to expenses for medication and physical therapy. Weaver, who was also pursuing a leadership degree while juggling adult classes, found herself postponing her graduation by a year because of unexpected medical bills.
“I had to do some figuring,” the 43-year-old from Sanford, Florida, recalled in an interview. “Could I cover tuition, books, living costs, and still care for my family?” It’s a disempowering feeling, she added, reflecting on the challenges of being a consumer in this situation.
Recent data reveals that Weaver’s struggles are increasingly common among Americans. The West Health-Gallup Affordability Index shows only about half of adults in the U.S. could afford health care costs and access quality care last year. Furthermore, the worries surrounding health care payments for the upcoming year are at an all-time high since the survey began in 2021, indicating a growing anxiety about rising health costs as we approach the end of 2025.
Americans are worried they won’t be able to pay their medical bills.
The index classified respondents into three categories based on their ability to access quality care and afford necessary medications. Currently, only 49% of U.S. adults are deemed “cost-safe,” meaning they can access high-quality, affordable care. This number has dropped from 56% in 2021 and peaked at 61% in 2022 but has been declining ever since.
The survey also showed that nearly 75% of adults view medical costs as a significant or minor financial burden, while only 30% reported they didn’t see it as a concern.
Moreover, around half of those surveyed expressed “very concerned” or “concerned” attitudes about their ability to cover necessary health care services in 2026, an increase from 42% in 2022.
Inger Perez, a 59-year-old from Encino, Texas, is one of the worried individuals. With a family history of diabetes, hypertension, and cancer, she recently underwent a blood test and is anxious about the results and the potential treatment costs.
“I cried last night. It’s been stressful thinking about what the results will show and how much it will cost,” she said. “Even if I start treatment, I’m worried I won’t be able to keep it up.”
Over half the respondents noted that medical expenses contribute “a lot” or “somewhat” to their daily stress. In contrast, around 30% claimed they hardly felt stressed by these costs.
Perez mentioned her dissatisfaction with the quality of care, particularly as she lives in a rural area that’s an hour away from the nearest clinic. Her budget led her to select a more affordable Affordable Care Act Marketplace plan, which has a limited network, complicating her access to the right care.
Health care affordability is declining across demographics
The findings also highlight a decline in health care affordability impacting various groups, including younger individuals, older adults, and women.
Only about a third of those under 30 are labeled “cost-safe,” down from 46% in 2021. Women, who were already less frequently “cost-safe” than men, saw the gap widen last year. In the latest survey, 57% of men felt “confident about costs,” a drop from 67% in 2022, versus just 42% of women.
Older Americans generally have more “cost security,” especially those enrolled in Medicare. Yet, this group also demonstrated a notable decline in confidence, from 73% in 2021 to 61% in 2025.
Patients make sacrifices to pay the bills
Many respondents shared sacrifices they made to handle rising medical bills. In 2025, nearly 20% stated they or someone in their household couldn’t afford a prescribed medication in the last three months due to costs. Additionally, about 30% indicated they forewent treatment for a health issue because of expenses.
Xavier Chapa, a 55-year-old father from Arizona, recounted how his wife is battling their insurance company over a necessary preventive colonoscopy. Despite verbal assurances of coverage, the insurance failed to follow through, leaving them with a looming $3,000 bill. This financial strain forced them to reduce their 8-year-old son’s summer camp from full to half-day, among other budget cuts.
“There’s a lot to manage,” he stated, reflecting on the difficulties of returning to America from Europe three years back. “What’s the point of living in this country if you face such high costs and can’t access basic necessities?”
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The West Health Gallup Center’s poll included 5,660 adults, conducted from late October to December 2025. The data featured in this survey stems from a sample drawn from Gallup’s probability-based panel. The margin of error for all adults is plus or minus 2.1 percentage points.
