Paul Sanchez
Despite the number of Americans with health insurance reaching historic highs during the COVID-19 pandemic, many Americans still cannot afford medical insurance. In 2021, there were just over 28 million uninsured Americans, and this number is likely to be higher today. Many Americans with insurance still face unaffordable medical bills, with 43% of those with employer coverage and 57% with marketplace plans reporting that they struggle to afford healthcare. This has led to significant medical debt, with 41% of Americans reporting debt due to medical or dental bills.
| Characteristics | Values |
|---|---|
| Percentage of Americans who can't afford medication and medical treatment | 11% |
| Percentage of Americans who believe they are paying too much for healthcare | 94% |
| Percentage of insured adults who worry about affording their monthly health insurance premium | 48% |
| Percentage of uninsured adults who face difficulty affording healthcare costs | 49% |
| Percentage of insured adults who face difficulty affording healthcare costs | 21% |
| Percentage of working-age adults with employer coverage who delayed or skipped care due to costs | 43% |
| Percentage of working-age adults with marketplace or individual plans who delayed or skipped care due to costs | 57% |
| Percentage of working-age adults with Medicaid who delayed or skipped care due to costs | 45% |
| Number of uninsured individuals in 2023 eligible for financial assistance | 14.5 million |
| Number of uninsured individuals in 2023 outside the reach of the ACA | 10.9 million |
| Number of Americans with health insurance during the COVID-19 pandemic | 299 million |
| Number of Americans without health insurance in 2021 | 28 million |
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What You'll Learn
Americans with insurance still can't afford healthcare
While the lack of insurance coverage is a significant factor in Americans' inability to afford healthcare, it is important to recognize that even among those with insurance, financial barriers to healthcare persist. A notable proportion of Americans with health insurance still struggle to afford medical care, highlighting the issue of inadequate coverage and the resulting financial burden. This situation has led to delayed or forgone treatment, significant medical debt, and deteriorating health for many.
A survey conducted in 2024 by West Health and Gallup revealed that a quarter of respondents with an annual household income below $24,000 faced difficulties in accessing or affording care within the previous three months. Additionally, 8% of white adults reported being unable to afford care, a figure that has remained unchanged since 2021. The survey also exposed widening disparities, with Black and Hispanic adults, as well as those with lower incomes, facing greater challenges in affording healthcare.
The Commonwealth Fund's 2023 Health Care Affordability Survey further emphasized the challenges faced by insured Americans. The survey found that a substantial number of working-age adults with employer-provided insurance (43%), marketplace or individual plans (57%), and Medicaid (45%) struggled to afford healthcare. Moreover, about half of insured adults (48%) expressed concern about managing their monthly health insurance premiums, with many rating their coverage as "fair" or "poor" regarding monthly premiums and out-of-pocket expenses.
The high cost of healthcare, including unexpected bills, prescription drug costs, and long-term care services, remains a significant concern for Americans, impacting their financial decisions and overall well-being. For many, health insurance fails to provide adequate financial protection against medical expenses, leading to a fear of incurring unmanageable healthcare costs. This fear often results in delayed or skipped treatment, exacerbating health issues over time.
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Racial disparities in healthcare affordability
Healthcare affordability is a significant issue in the United States, with many Americans facing barriers to accessing necessary medical care. This issue disproportionately impacts people of colour, exacerbating existing racial disparities in healthcare.
A survey conducted in 2024 by West Health and Gallup found that over a third of American adults, representing approximately 91 million people, could not afford medical care if they needed it. Notably, this survey also revealed widening disparities for Black and Hispanic adults, with a quarter of those earning less than $24,000 annually reporting an inability to afford or access care. This data highlights the intersectional nature of healthcare disparities, which are influenced by factors such as race, income, and citizenship status.
The Biden Administration has taken steps towards addressing these disparities, including expanding the Child Tax Credit, which led to significant reductions in child poverty rates, particularly for Black and Hispanic children. However, the expiration of this expansion at the end of 2021 caused poverty rates to rebound, underscoring the need for sustained and comprehensive policy changes.
Transformative change requires addressing unequal access to care and unequal treatment within healthcare facilities. Policy options should focus on ensuring universal, affordable, and equitable health coverage for all Americans, regardless of race or ethnicity. This includes expanding access to primary care, which has been shown to improve health outcomes, particularly for Black, Latinx/Hispanic, and AIAN communities that have historically faced barriers to utilizing primary care services.
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Healthcare costs affect insurance coverage
Healthcare costs are a significant factor influencing insurance coverage in the United States. The high cost of healthcare can deter people from seeking medical care, even those with insurance, as they may fear unaffordable expenses. This results in delayed or forgone care, causing health conditions to worsen. According to a survey, 11% of Americans faced difficulty paying for medication and medical treatments. Moreover, more than a third of respondents, representing 91 million adults, stated that they would be unable to pay for medical care if needed.
The cost of health insurance itself also affects coverage. Many Americans struggle to afford health insurance, with some facing a choice between paying for insurance and other essential expenses. This is particularly challenging for those without employer-sponsored coverage, as individual market plans tend to have higher premiums and contributions. The concentration of insurance companies in certain states, due to mergers and acquisitions, has resulted in decreased competition, higher premiums, and reduced access to affordable health insurance.
While Medicaid and subsidized Marketplace coverage provide financial assistance to those who are uninsured, there are still barriers to enrollment. Some individuals may be unaware of these options, and even with subsidies, the coverage may remain unaffordable. Additionally, eligibility for Medicaid varies across states, with some states not adopting the ACA expansion, leaving adults with limited access.
The financial implications of being uninsured can be significant. Uninsured individuals often face unaffordable medical bills when they seek care, leading to medical debt. This debt can have a detrimental impact on their overall financial well-being. Even those with insurance may struggle with medical debt, as out-of-pocket expenses, including copays, deductibles, and coinsurance, can quickly accumulate.
The relationship between healthcare costs and insurance coverage is complex. While insurance can provide financial protection, the rising cost of healthcare and insurance premiums can make it challenging for many Americans to access affordable care and coverage. This, in turn, can lead to delayed treatment, worsening health conditions, and significant medical debt. Addressing the root causes of high healthcare costs and improving insurance coverage are crucial steps towards ensuring that all Americans can access the healthcare they need without facing financial hardship.
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Americans delay or forgo healthcare due to costs
The high cost of healthcare in the United States is a significant burden for many Americans. While the number of Americans with health insurance climbed to historic highs during the COVID-19 pandemic, many of these policies offer limited financial protection, causing patients to delay or forgo medical care and prescriptions to avoid out-of-pocket costs. This means that even those with insurance are endangered by the prospect of unaffordable healthcare expenses.
A 2023 survey by the Commonwealth Fund found that many Americans have inadequate health insurance coverage, leading to delayed or forgone care, significant medical debt, and worsening health problems. This is supported by a 2024 Gallup-West Health survey, which found that over 91 million adults said they would not be able to pay for medical care if they needed it. The survey also showed that Black and Hispanic adults, as well as those with lower incomes, are more likely to face problems with paying for medical treatment.
A 2024 CBS News study found that almost half of Americans cannot afford healthcare, with 43% of those with employer coverage, 57% with marketplace or individual plans, and 45% with Medicaid struggling to pay for healthcare. Furthermore, a 2025 New York Times survey found that 11% of Americans could not afford medication and medical treatment in the previous three months, the highest level in the four years the survey had been conducted.
The high cost of healthcare in the US is influenced by various factors, including higher inflation and long-term trends toward insurance plans with higher deductibles and less comprehensive coverage. Additionally, the fear of unexpected medical bills and the cost of health care services, including out-of-pocket costs not covered by insurance, prescription drug costs, and long-term care services, contribute to the financial burden of healthcare for Americans.
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Healthcare costs are a top financial worry
A 2024 study by West Health and Gallup found that over 91 million adults would not be able to pay for medical care if they needed it. This survey also highlighted the widening gap in healthcare access for Black and Hispanic adults, with nearly a quarter of those with an annual household income of less than $24,000 unable to afford or access care.
The concern over healthcare expenses is not limited to the uninsured. Many insured Americans also face challenges due to inadequate coverage, high deductibles, and out-of-pocket costs. About 43% of those with employer coverage, 57% with marketplace or individual plans, and 45% with Medicaid report struggling to afford healthcare. This has led to significant medical debt and worsening health problems, even for those with insurance.
The high cost of healthcare in the United States has resulted in difficult choices for individuals and families. Many are forced to decide between essential needs, such as rationing food or forgoing vacations, to pay for their health expenses. This has led to a decline in overall health and well-being for Americans.
The COVID-19 pandemic brought some relief, with historic highs in the number of insured Americans. However, this progress was tempered by the reality that many of these policies provided limited financial protection, leading to patients forgoing care or prescriptions to avoid out-of-pocket costs. As a result, healthcare costs continue to be a pressing financial concern for Americans, influencing their decisions about insurance coverage and care-seeking behaviours.
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Frequently asked questions
In 2024, almost half of Americans couldn't afford medical care. A survey conducted in 2024 found that more than a third of those surveyed, representing 91 million adults, said that they would not be able to pay for medical care if they needed it. Another survey found that 11% of Americans said they could not pay for medication and medical treatments.
There are several reasons why Americans can't afford medical insurance. Firstly, insurance plans with higher deductibles and less comprehensive coverage have made it harder for people to afford care. Secondly, higher premiums and the added cost of doctor's visits have contributed to the problem. Finally, the recent rollback in Medicaid coverage has also made it more difficult for people to access affordable healthcare.
Not being able to afford medical insurance has several negative consequences. People without insurance are less likely to access care and more likely to delay or forgo it due to costs. This can lead to significant medical debt and worsening health problems.
There are several potential solutions to help Americans who can't afford medical insurance. Firstly, increasing subsidies and financial assistance for those who are uninsured or underinsured can help improve access to healthcare. Additionally, expanding Medicaid coverage and removing eligibility restrictions can help more people access affordable healthcare. Finally, addressing the high cost of healthcare and reducing out-of-pocket expenses can make a significant difference in improving access to healthcare for all Americans.
