Gallup Survey Reveals Record High in Americans Unable to Afford Healthcare

The percentage of U.S. adults who are unable to afford or access quality healthcare has hit its highest level since 2021, according to the latest West Health-Gallup Healthcare Indices Study. The report finds that 11% of adults—nearly 29 million people—are now classified as “Cost Desperate”, meaning they lack access to quality, affordable care and have recently been unable to pay for needed care and medications.

The crisis has disproportionately impacted Hispanic and Black Americans, and those living in low-income households. Since 2021:

• The share of Hispanic adults in the Cost Desperate category has climbed 8 points to 18%
• Black adults have risen 5 points to 14%
• Adults in households earning under $24,000 annually jumped 11 points to 25%

By contrast, White adults and middle- to high-income groups have experienced little to no change, widening disparities in healthcare affordability across race and income levels.

A Growing Divide in Healthcare Access

The Healthcare Affordability Index groups Americans into three categories:

• Cost Secure – Have access to affordable care and can pay for it
• Cost Insecure – Struggle to access care or afford it
• Cost Desperate – Cannot access or afford care and have recently gone without

In 2024, only 51% of Americans are Cost Secure, down from previous years. The most significant declines occurred among:

• Hispanic adults (down 17 points to 34%)
• Black adults (down 13 points to 41%)
• Lowest-income households (down 14 points to 23%)
• Lower-middle-income households ($24K–$48K: down 12 points to 30%)

Meanwhile, the Cost Insecure group now accounts for nearly 4 in 10 adults, and continues to show similar disparities:

• 48% of Hispanic adults
• 45% of Black adults
• Over 50% of those earning less than $48K

These findings underscore a widening gap between Americans who can afford care and those increasingly left behind.

One in Three Americans Can’t Access Affordable Care

Among the three main affordability indicators, access to affordable, quality healthcare when needed has become especially dire. In 2024:

• 35% of Americans say they cannot access affordable, quality care—a 4-point rise from 2023 and the highest since 2021
• For households earning under $24K, that number surged 11 points to 64%
• For households earning $24K–$48K, it jumped 12 points to 57%

In contrast, higher-income households (earning $120K+) report no significant change, further expanding the access gap between income groups.

The Real-World Costs of Healthcare Insecurity

The decline in healthcare affordability is taking a serious toll on American families:

• 12% of U.S. adults borrowed money to pay for care in the past year—totaling an estimated $74 billion
• Nearly 60% fear going into debt due to a medical emergency
• Many report cutting back on food, transportation, and utilities, or staying in jobs only for the health benefits

These financial strains are contributing to elevated stress, worsened health outcomes, and rising inequities in care. The surge in Cost Desperate Americans is a clear signal of a system under pressure.

What’s Driving the Crisis?

The report suggests multiple factors contributing to the worsening affordability landscape, including:

• Medical and consumer inflation
• Drug shortages
• Medicaid disenrollments following the end of the continuous coverage rule
• Cuts to the Children’s Health Insurance Program (CHIP)

Together, these dynamics are deepening the divide between the healthcare haves and have-nots—a gap that has reached its widest point since tracking began.