The Cost of Care Is Making Some Americans Choose Between Their Health and Their Finances
Rising medical costs are changing how Americans use the healthcare system. New 2026 research shows that people are delaying care, struggling with medical debt and sometimes cutting back on essential household expenses to pay their bills.
For many Americans, the hardest part of going to the doctor is no longer finding an appointment. It is wondering what the appointment will cost.
That financial anxiety has become an important health issue in its own right. In 2025, about 36% of U.S. adults said they had skipped or postponed healthcare they needed because of cost, according to KFF. Nearly two-thirds of adults also said they were at least somewhat worried about being able to afford healthcare for themselves or their families.
The problem does not disappear simply because someone has health insurance.
Insurance Does Not Always Mean Affordable Care
Health insurance can protect people from the full cost of major medical treatment, but deductibles, copayments, coinsurance, premiums and uncovered services can still create substantial financial pressure.
New research from the Commonwealth Fund, published in September 2026, found that 32% of working-age adults with private insurance were paying off medical bills or medical debt over time.
Among privately insured adults who had medical debt, 37% had used some or all of their savings to pay their bills. About 30% said they had delayed or avoided needed healthcare, while another 30% reported cutting back on basic necessities such as food, heat or rent.
That is more than a financial problem.
When people postpone appointments, diagnostic tests or treatment because they fear another bill, a health problem that might have been manageable can become harder to address.
Prescription Costs Can Change the Way People Take Medicine
Medication affordability is another part of the problem.
KFF’s 2026 Health Tracking Poll found that 43% of U.S. adults said they had not taken medication as prescribed during the previous year because of cost. That included people who substituted over-the-counter medicines, did not fill a prescription, or skipped doses or split pills to make medication last longer.
For people living with conditions that require regular treatment, these decisions can have serious consequences.
The issue is particularly important for older adults, who are more likely to take several medications at once. Even when individual prescriptions appear manageable, the combined cost of multiple medicines can become difficult for a household budget.
Medication changes should not be made simply because a prescription is expensive. Patients who are struggling with costs can tell their doctor or pharmacist. Depending on the medicine and insurance coverage, there may be lower-cost alternatives or other legitimate ways to reduce expenses.
Medical Debt Can Follow People Long After Treatment
A hospital visit may last a few hours. The bill can remain for months or years.
The Commonwealth Fund’s latest research found that medical debt can affect savings, household budgets and emotional wellbeing. Among people with unpaid medical bills, 68% said the debt caused worry or anxiety, while more than one-third reported using savings to deal with medical expenses.
This creates a difficult cycle.
A person worries about the cost of seeking care, delays the appointment, and then may face a more complicated health problem later. The resulting treatment can be more expensive, creating even greater financial pressure.
Research cannot say that every delayed appointment will lead to worse health. But the pattern is concerning because preventive care and early treatment are important parts of managing many diseases.
Healthcare Spending Is Still Rising
The affordability challenge is occurring against a broader backdrop of increasing healthcare spending.
The Centers for Medicare & Medicaid Services projects that U.S. national health expenditures will grow by an average of 5.4% annually between 2025 and 2034, faster than projected GDP growth of 4.1% per year. CMS projects retail prescription drug spending to grow by an average of 5.7% annually over the same period.
Those figures do not mean every patient’s bill will rise at the same rate. Insurance coverage, income, location, medical needs and the type of care received all make a difference.
But they help explain why healthcare affordability remains such a persistent concern.
Older Adults Face a Different Set of Pressures
For older Americans, Medicare provides an important layer of protection, but healthcare expenses do not disappear after retirement.
People may still have premiums, prescription costs, dental and vision expenses, specialist copayments and other out-of-pocket bills.
There is also encouraging news for Medicare beneficiaries looking ahead to 2027. CMS projects that the average monthly Medicare Advantage premium will fall from $14.37 in 2026 to about $12 in 2027. However, premiums are only one part of the equation. Deductibles, copayments, provider networks and prescription coverage can all affect what a person actually spends.
That makes understanding a health plan increasingly important—not simply choosing the plan with the lowest monthly premium.
When Healthcare Affordability Becomes a Public-Health Issue
Healthcare costs are often discussed as an economic problem, but their effects reach directly into people’s health.
A person who postpones a screening, avoids a specialist, does not fill a prescription or delays treatment is making a healthcare decision based partly on finances.
And the consequences can extend beyond the individual. Medical debt can drain household savings, increase stress and force families to make difficult choices between healthcare and everyday necessities.
The latest evidence does not suggest that every American is facing the same level of financial hardship. But it does show that affordability remains a significant barrier to care—even among people who have insurance.
Healthcare should not be viewed only through the question of whether someone technically has coverage. A more meaningful question is whether that person can realistically use the healthcare they have access to.
For millions of Americans, that distinction is becoming impossible to ignore.
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