Americans are heading into 2026 with record-high concern about health care costs, according to a new West Health–Gallup survey that reveals rising anxiety, increased financial strain, and widening gaps in access across the country. Nearly half of U.S. adults (47%) say they’re worried they won’t be able to afford the care they need next year—the highest level reported since the organizations began tracking these trends in 2021.
The survey, which collected responses from roughly 20,000 adults across all 50 states and Washington, D.C., shows stark increases in stress related to medical bills, prescription prices, and delayed care. And for millions, those financial pressures are already affecting real-world decisions.
Prescription Drug Costs and Daily Stress Are Rising
Americans are increasingly anxious about the price of medications. The share of adults worried about affording prescriptions has climbed to 37%, up from 30% in 2021—the highest level recorded by West Health and Gallup.
Financial stress is also worsening:
- 15% now say health care costs cause “a lot of stress” in their daily lives, nearly double the rate in 2022
- About 1 in 3 people skipped or delayed medical care in the last year because they couldn’t afford it
Experts warn that this creates a dangerous cycle, where postponing care leads to more serious—and more expensive—health issues later on.
Where You Live Plays a Big Role in Health Care Access
The survey highlights major geographic differences in access and affordability:
Top-ranked states: Iowa, Massachusetts, Washington, D.C., Rhode Island
Lowest-ranked states: Texas, New Mexico, Nevada, Alaska
Even in the states with better health care experiences, affordability remains a challenge:
- 15% couldn’t pay for a prescription in the past three months
- 25% skipped recommended tests or procedures due to cost
In the lowest-ranked states, the numbers rise sharply:
- Nearly 30% couldn’t afford medications
- 40% skipped needed tests or procedures
- States like Texas, Montana, and Alaska saw more than 4 in 10 adults delay care
Long wait times and work schedules also created barriers: 55% reported delays due to wait times, and 27% cited difficulty fitting appointments into work hours.
What Policy Experts Are Watching in 2026
Health care costs remain a central political issue heading into the new year. Enhanced Affordable Care Act (ACA) subsidies—credited with protecting families from steep premium hikes—are set to expire on December 31, after efforts to extend them stalled in Congress.
Policy analysts say the expiration of these subsidies, along with Medicaid work requirements scheduled for 2027 (which could result in 4.8 million people losing coverage), may further heighten Americans’ concerns about affordability.
“The urgency is real,” said Timothy Lash of West Health. “Families are already stretched thin, and every metric we track is getting worse.”
The Bottom Line
The 2026 outlook shows a nation increasingly strained by rising health care costs, uneven access, and growing pressure on household budgets. As medical expenses continue to climb and policy changes approach, millions of Americans may face even tougher challenges in getting the care they need.
