Fifty-five percent of U.S. adults were readily able to afford and access healthcare or medicine in late 2023, according to a survey by Gallup and healthcare policy organization West Health, the lowest share of respondents since the two firms began tracking healthcare affordability in 2021.
Healthcare affordability was more elusive for younger adults in the survey of 5,149 respondents ages 18 and older, conducted between Nov. 13, 2023, and Jan. 8, 2024. Forty-seven percent of those ages 18 to 49 said they were “cost secure,” i.e. had no recent problems affording care or medicine. That’s down from 2022, when 52% of this age group said they were cost secure.
Healthcare cost security declines, with younger adults particularly cost insecure
% of U.S. adults categorized as cost secure by age group between 2021-2023
The share of Americans who were either “cost insecure” or “cost desperate” — which Gallup and West Health defined as being both recently unable to pay for and lacking access to care — also increased since 2022. Thirty-seven percent of respondents said they were cost insecure in 2023 and early 2024, compared to 32% in 2022.
Gallup and West Health’s findings reflect broader healthcare affordability concerns both within and outside of the employer-sponsored health insurance market. Mercer found in a survey published last month that most employers planned to maintain their current level of health benefits for 2025, even as per-employee cost increases rose from 5.2% year-over-year between 2023 and 2024 and after nearly a full decade of 3% annual cost growth.
While the share of employees who said they were cost desperate in Gallup and West Health’s survey was the same in 2023 and early 2024 as it was in 2021 at 8%, the firms noted that cost desperate status is on the rise for patients who are Black or Hispanic relative to White patients.
Those who are cost desperate are at least 10 times likely to have to cut back on utilities and food to pay for care within the past year and seven times more likely to have had a family member or friend who died in the past year because of an inability to pay for treatment, the firms said.
Delayed care is a concern even for workers who purchase health insurance through their employers. Healthcare vendor Paytient said in a March study that some 40% of U.S. workers said they postponed their healthcare needs over concerns about cost.