Health care affordability in the U.S. keeps slipping
Fewer than half of American adults can now reliably afford health care and prescription drugs, according to new findings from the West Health-Gallup Center on Healthcare in America. The group’s latest Healthcare Affordability Index places 49% of U.S. adults in the “Cost Secure” category for 2025, the lowest level recorded since the index began in 2021.
The result is notable not only because it drops below the halfway mark, but because it extends a pattern rather than representing a one-off decline. In the past year alone, 2.8 million Americans fell out of the Cost Secure category, according to the research summarized by Medical Xpress. That suggests financial pressure is widening, not stabilizing, even after several years of public debate over medical inflation, insurance premiums and drug prices.
The data point to a country in which access to care is increasingly shaped by household finances. When affordability weakens at this scale, the issue does not remain confined to insurance design or budgeting. It spills into delayed treatment, skipped prescriptions and worsening disparities across communities that were already vulnerable.
What “Cost Secure” means
The West Health-Gallup index measures Americans’ ability to access and pay for needed health care and medications based on self-reported survey responses. People are sorted into categories that reflect how consistently they can get care when they need it and whether they can pay for that care without major strain.
In this year’s findings, 49% qualified as Cost Secure. That leaves a majority outside the most stable affordability category. The report also notes continuing declines among groups that have historically faced greater barriers, including Black and Hispanic adults and lower-income households.
Those demographic gaps matter because they indicate the affordability problem is not evenly distributed. Rising costs may affect everyone, but they hit households with less income flexibility first and hardest. When medical costs rise faster than wages or savings, people with fewer cushions are more likely to postpone care, split prescriptions, or forgo treatment entirely.
Rising spending helps explain the pressure
The affordability downturn arrives alongside continued growth in U.S. health spending. The report cited by Medical Xpress says national health care spending reached $5.3 trillion in 2024, up 7.2% from the previous year. That growth rate was more than twice overall inflation, which stood at 2.9%.
Specific cost categories also moved upward. Hospital prices rose 3.4% in 2024, the fastest increase since 2007, while prescription drug spending climbed 7.9%. Those figures help explain why affordability can erode even when the broader inflation picture appears less severe than in earlier post-pandemic years. For households, the relevant question is not whether inflation is cooling in general, but whether the bills that matter most are becoming easier to absorb. On current evidence, health care is not.
That mismatch between medical cost growth and overall inflation is especially important because families do not experience categories of spending in isolation. If housing, food or transportation remain expensive while medical costs also rise faster than general prices, health care becomes one more pressure point in a budget already under strain.
Why the decline carries policy weight
Tim Lash, president of the West Health Policy Center, warned that the finding should alarm policymakers and health care leaders. His argument, as cited in the report, is straightforward: costs are rising faster than people’s ability to pay, and without meaningful reform, affordability will continue to deteriorate.
That warning lands in a policy environment where health care affordability is often discussed in fragments. Prescription drugs, insurance premiums, hospital pricing and care delivery reform are frequently debated as separate issues. The index pulls those threads together by asking a practical question from the patient’s point of view: can people get the care and medicine they need, consistently, without financial breakdown?
By that standard, the answer is worsening. And because the measure is based on lived experience rather than on a single premium benchmark or utilization rate, it captures the cumulative effect of a system that can appear functional in the aggregate while failing many people at the point of use.
Affordability is becoming a structural concern
The latest reading suggests the problem is moving beyond cyclical stress. A drop below 50% in the Cost Secure category means affordability is no longer a challenge affecting a large minority while leaving most households insulated. It now describes a country where a majority of adults are outside the most stable affordability bracket.
That shift has broader implications. If more people struggle to pay for care, providers may see more delayed presentations and more uncompensated or disrupted treatment paths. Employers and public programs may also face greater downstream costs if preventive care becomes harder to access and routine medication adherence declines.
The report does not attempt to solve those questions on its own, but it sharpens them. For business leaders, lawmakers and health systems, the takeaway is that affordability is not a peripheral consumer complaint. It is becoming a structural constraint on access.
What the new data make clear
The headline figure, 49%, is important because it converts a diffuse national concern into a measurable threshold. It shows that health care affordability in the United States has fallen to its weakest point in the five-year history of this index, and that millions more people have lost stable footing in just one year.
Just as importantly, the supporting data explain why. Health spending is growing quickly, hospital prices are climbing at their fastest pace in many years, prescription drug spending continues to rise, and the burden is falling disproportionately on communities with the fewest resources to absorb it.
There will be debate over which policy lever matters most, whether that is delivery reform, drug pricing action, insurance redesign or broader cost controls. But the new index reading narrows the room for pretending the issue is marginal. On the available evidence, affordability is deteriorating in a way that is broad, measurable and increasingly difficult to ignore.
This article is based on reporting by Medical Xpress. Read the original article.
Originally published on medicalxpress.com
