New findings from the latest West Health–Gallup Healthcare Affordability Index, which tracks Americans' ability to access and pay for health care, show that fewer than half of U.S. adults (49%) can consistently afford the care and prescription medications they need when they need them. Over the past year alone, 2.8 million Americans have fallen out of this "Cost Secure" category, unable to keep pace with rising health care costs — bringing affordability levels to their lowest point since the Index launched in 2021.
The new data largely extend last year's downward trends, with continued declines in affordability evident among traditionally vulnerable populations, including Black and Hispanic adults and lower-income households.
"The fact that fewer than half of Americans can reliably afford healthcare should alarm every person, policymaker and healthcare leader in the country," said Tim Lash, President, West Health Policy Center. "Millions of Americans are being priced out of health care because costs are rising faster than their ability to pay. Without meaningful reforms that better address healthcare delivery, high prescription drug prices and rising insurance premiums, Americans will continue to struggle and affordability will only continue to deteriorate."
Black and Hispanic adults, the middle class and young adults are struggling the most. Currently, just 38% of Black adults and 32% of Hispanic adults are classified as "Cost Secure," compared with 55% of White adults. Notably, since 2021, these gaps have consistently widened, with cost security declining more dramatically among Black (-16 percentage points) and Hispanic (-19 percentage points) adults than among White adults (-3 percentage points).
About 1 in 3 adults in households earning between $120,000 to $179,999 were not "Cost Secure" in 2025, nor were even 1 in 5 earning $180,000 or more. Additionally, adults aged 18 to 29 saw the sharpest decline in health care affordability. Less than a third of this group (32%) were "Cost Secure" in 2025, 1 17-point decline since 2021 and a seven-point drop in the last year alone.
These findings underscore a deepening health care affordability crisis in the United States, marked by widening disparities across demographic groups and sustained pressure on households' ability to absorb rising medical and prescription drug costs.
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