U.S. healthcare affordability hits a five-year low

For the first time since tracking began five years ago, most Americans can no longer say they can reliably afford their healthcare. New data from the West Health-Gallup Healthcare Affordability Index shows a steady, years-long erosion in patients' ability to pay for the care and medications they need, and the trend line is only pointing in one direction.

The pressure is not landing evenly. Some age groups are losing ground faster than others, and the gap between men and women has widened to its largest point on record. Patients managing chronic and mental health conditions, the people who most depend on consistent access to care, are also feeling the squeeze more acutely than the general population. Meanwhile, rising health spending, climbing hospital prices, and the recent expiration of enhanced ACA subsidies are compounding an already difficult picture heading into 2026.

These findings track closely with what physicians are already telling Medical Economics: nearly half of patients struggled to afford care in 2025, and many doctors are increasingly worried about the patient affordability crisis playing out in their own practices. As concern about paying for care climbs to a new high, understanding exactly who is being squeezed, and by how much, matters more than ever for physicians navigating these conversations with patients.

Here are the key findings: