The cost of healthcare continues to be a problem for millions of American families. According to a new study from the nonpartisan Urban Institute, 46% of adults between the ages of 18 and 64 had difficulties affording healthcare in 2025.
To determine the severity of the problem with healthcare affordability, the researchers looked at three possible issues in a survey of more than 10,000 adults: difficulties paying medical bills in the last year; avoiding a needed service due to cost in the last year; and carrying medical debt. The second category was the largest, with about 35% saying that they or someone in their household did not get healthcare they needed at some point in the last year due to cost. Nearly 30% said their family is currently carrying medical debt, while about 17% said they had trouble paying a medical bill in the last year.
Those without health insurance typically report the most problems affording care, but even those with insurance struggle with costs as premiums, deductibles and copayments claim a growing share of household incomes. About 39% of those who had insurance reported having at least one problem with affordability, compared to 53% of those with a public marketplace plan, 57% of those with Medicaid and 60% of those with no insurance.
Some demographic groups reported more difficulties than others. About 69% of those with a disability struggled to afford their healthcare last year, as did 60% of those with a serious health condition such as stroke, cancer, heart disease or diabetes. About 56% of Black and Hispanic respondents said they struggled with affordability, compared to 42% of whites and 28% of Asians.
A growing challenge: More people are expected to experience problems with healthcare affordability as the cost of both private and public medical care continues to rise.
Katherine Hempstead, a senior policy advisor at the Robert Wood Johnson Foundation, which helped fund the study, said the high cost of care could have a negative effect on the health of millions of people.
“Affordability of health care is now everyone's concern, not just people who are uninsured,” Hempstead said in a press release. “Higher out-of-pocket costs for insurance premiums and cost sharing make many people less secure and potentially less healthy as they avoid needed care.”
Michael Karpman, one of the researchers on the project, noted that new government policies could make matters worse. “These findings highlight widespread difficulty in affording health care across the United States,” he said in a statement. “Recent federal policy changes could exacerbate these difficulties by increasing the number of people who are uninsured. And if more employers shift the rising costs of health care to their employees, affordability challenges will increase.”