Healthcare Costs are Forcing Americans to cut Daily Spending

Financial pressures are mounting across American households as the cost of living continues to rise. 

However, healthcare expenses are emerging as a particularly significant burden, forcing millions to make difficult choices about their daily lives and future plans.

The West Health-Gallup Affordability Index suggests that Americans' ability to afford healthcare has worsened between 2020 and 2025. 

As some Affordable Care Act subsidies are set to expire in 2026 and Medicaid enrolment faces cuts, millions could face higher insurance premiums and increased out-of-pocket costs.

Research from the West Health-Gallup Center on Healthcare in America reveals the extent to which healthcare costs are influencing American life. 

People are cutting back on utilities, driving less to save fuel costs and stretching prescription drug doses to manage healthcare expenses.

Daily sacrifices for medical care

A nationally and state-representative survey of nearly 20,000 American adults, conducted between June and August 2025, found that roughly one-third of respondents had made at least one trade-off with daily living expenses to afford healthcare. 

This represents more than 82 million Americans.

The financial burden falls most heavily on those without health insurance. 

According to the research, 62% of uninsured Americans have made at least one sacrifice to pay for healthcare, including 32% who have borrowed money and 24% who have prolonged medication. 

However, close to three in ten insured individuals also made at least one sacrifice.

Income level plays a significant role. More than half of adults in households earning less than US$24,000 annually report having made at least one trade-off to pay for healthcare, whilst 47% of those earning between US$24,000 and US$48,000 face similar pressures.

However, the issue reaches further up the income scale than many might expect. A quarter of adults in households earning between US$90,000 and US$120,000 annually report making such trade-offs, representing approximately 9 million people. Even among households earning US$240,000 or more, 11% report making sacrifices.

Geographic disparities in healthcare affordability

In 2025, the West Health-Gallup Center on Healthcare in America released state rankings based on Americans' experiences with healthcare costs. 

Residents in states ranking in the bottom 10 were substantially more likely to report making financial trade-offs compared with those in the top 10 states.

People in lower-ranking states were nearly twice as likely to report stretching prescriptions or borrowing money. 

However, even in top-ranking states such as Massachusetts, Rhode Island and Iowa, about one in ten people still report taking these actions.

Regional variations reflect broader structural differences in state healthcare systems, insurance markets and cost of living. 

States that expanded Medicaid under the Affordable Care Act typically show better affordability outcomes. 

Rural residents often face higher costs due to limited provider competition and longer travel distances for care.

Timothy Lash, President of West Health Policy Center, a non-profit organisation focused on healthcare and aging, says: "We're actually finding that people are reporting higher incidences of metabolic disease or depression and anxiety. 

“We're not getting healthier as a society, we're actually getting sicker, and the healthcare cost is ​going up on top ​of it.”

Impact on long-term planning

Healthcare costs are influencing major life choices. A nationally representative survey of 5,660 American adults, conducted between October and December 2025, revealed that people have delayed significant life events between 2021 and 2025 due to healthcare costs.

Nearly one in ten adults, representing an estimated 24 million Americans, say they have postponed their retirement due to healthcare costs.

Twice as many, at 18%, report delaying a job change. 

Meanwhile, 14% have put off buying a new home and 6% say they have postponed growing their family.

The findings demonstrate that healthcare affordability has become a significant economic and societal challenge affecting nearly every aspect of life. 

Whilst low-income households and those lacking health insurance are most acutely affected, the fact that even many Americans with six-figure incomes report making financial sacrifices suggests that affordability challenges are systemic rather than isolated to any single group.