How confident are you that you could afford necessary medical care if you needed it?

Background

Health care affordability has become the top concern for Americans in 2026, surpassing even the economy. According to Gallup, 61 percent of U.S. adults say the availability and affordability of health care is a concern of great importance this year, outpacing the economy by ten percentage points. A January 2026 KFF Health Tracking Poll found that many Americans may be one unexpected medical bill away from falling into debt, with about half of U.S. adults saying they could not pay an unexpected $500 out-of-pocket medical bill without borrowing or going into credit card debt. The issue has intensified as insurance premiums have risen, the enhanced Affordable Care Act premium tax credits expired at the end of 2025, and Medicaid enrollment has narrowed following recent federal legislation. A West Health-Gallup survey found that almost half of adults entered 2026 worried they would not be able to afford health care, and polling from the PAN Foundation shows that 54 percent of Americans are concerned about their ability to continue affording monthly health insurance premiums this year.

Those who believe the current system needs significant reform point to data showing that just under half of adults say it is difficult to afford health care costs, according to KFF, and that about three in ten Americans delayed or went without medical care in the past year due to cost, according to The Century Foundation. They argue that rising premiums, high deductibles, and gaps in coverage leave families vulnerable to financial ruin, noting that about 41 percent of adults carry some form of medical or dental debt. On the other side, others note that a majority of insured Americans rate their coverage favorably, and an eHealth survey found that 77 percent of Americans were satisfied with their health insurance options heading into 2026. Proponents of more market-oriented approaches contend that expanding consumer choice, reducing regulatory burdens, and increasing competition among insurers and providers can lower costs without major new government spending.

What is at stake extends well beyond hospital bills. Research from Johns Hopkins Bloomberg School of Public Health found that people with medical debt had a 44 percent higher risk of subsequent housing instability, including difficulty paying rent or mortgage. Consumer Reports notes that over 500,000 medical bankruptcies are filed annually in the United States. The burden falls unevenly: KFF data show that Hispanic adults, Black adults, women, low-income households, and the uninsured are disproportionately likely to struggle with health care costs. With health care affordability poised to be a defining issue in the 2026 midterm elections, the choices policymakers make about insurance subsidies, Medicaid funding, drug pricing, and medical debt protections will shape whether more Americans can confidently access the care they need.