1 in 3 Americans Sacrificed for Healthcare Costs: Survey Reveals Financial Strain

Nearly one-third of Americans report having to build sacrifices – from skipping meals to rationing medication – to afford healthcare costs, according to a survey released Thursday. This underscores a growing financial strain on households across income levels, prompting difficult choices as medical expenses continue to rise.

The West Health-Gallup Center survey, gathering responses from 20,000 participants in 2025, estimates that over 82 million Americans have had to compromise on basic needs to cover medical bills. This isn’t simply a budgeting issue for a compact segment of the population; the data reveal that even 11% of households considered “well-off” are making trade-offs to manage healthcare expenses. The findings come as the cost of living remains a central concern for voters, and as expiring subsidies related to the Affordable Care Act threaten to exacerbate the problem in 2026.

The Broader Context of US Healthcare Spending

The United States consistently spends more on healthcare per capita than other wealthy nations, yet doesn’t consistently achieve better health outcomes. According to data from the Centers for Medicare & Medicaid Services (CMS), total health spending reached $4.9 trillion in 2022. KFF reports that health care costs generally grow faster than inflation, representing a significant share of the US economy. This high spending doesn’t translate into universal access or affordability, leaving many Americans vulnerable to financial hardship when medical needs arise.

The survey data aligns with other recent findings. Another West Health poll of 5,660 Americans at the end of 2025 revealed that many are delaying necessary medical treatments and surgical procedures due to cost. Specifically, 14% of respondents reported postponing a home purchase, 9% delayed retirement plans, and 6% place off starting or expanding a family because of healthcare costs. These decisions have far-reaching consequences, impacting not only individual well-being but as well broader economic trends.

Who is Most Affected?

Whereas the burden of high healthcare costs is widespread, certain populations are disproportionately affected. The survey highlights that those who are uninsured or underinsured are most likely to cut corners on essential expenses. However, the fact that over 10% of higher-income households are also making sacrifices demonstrates the pervasive nature of the problem. This suggests that even with insurance coverage, deductibles, co-pays, and uncovered services can create significant financial barriers to care.

The impact extends beyond immediate financial strain. The delays in care documented in the West Health surveys can lead to more serious health problems down the line, potentially increasing healthcare costs in the long run. The decision to postpone having children, for example, represents a deeply personal and potentially irreversible consequence of unaffordable healthcare.

The Role of the Affordable Care Act and Potential Changes

The Affordable Care Act (ACA), also known as “Obamacare,” has played a role in expanding health insurance coverage in the US. However, expiring subsidies tied to the ACA are expected to worsen the affordability crisis in 2026. These subsidies have been shielding millions of Americans from higher health insurance premiums, and their expiration could push coverage out of reach for many. The Health System Tracker provides detailed data on national health expenditure trends, illustrating the ongoing challenges of controlling costs and ensuring access to care.

A Systemic Issue, Not Just Personal Finances

Tim Lash, president of the West Health Policy Center, emphasized that the widespread sacrifices being made are indicative of a systemic failure. “When families across every income level are forced to choose between medical bills and paying their heating or electric bill, that’s not a personal budgeting problem—it’s a systems failure,” he stated. This points to the need for broader policy solutions that address the underlying drivers of high healthcare costs.

The US healthcare system differs significantly from those in other developed countries, such as France, which have universal public health insurance. While the US spends more, it often lags behind peer nations in key health indicators like life expectancy. This discrepancy raises questions about the efficiency and effectiveness of the current system.

Understanding Health Expenditure Trends

Looking at historical data, health spending in the US has risen dramatically over the decades. In 1970, total health expenditures were $74.1 billion. By 2000, they had climbed to approximately $1.4 trillion, and in 2024, spending exceeded $5.3 trillion. The Peter G. Peterson Foundation offers insights into the factors driving these increases, including technological advancements, an aging population, and administrative costs.

The growth in health spending from 2023 to 2024 (7.2%) is higher than the average annual growth rate of the 2010s (4.2%), indicating an acceleration of the problem. Adjusting for inflation, national health spending increased 4.4% in 2024.

What’s Next: Policy Debates and Potential Solutions

The issue of healthcare affordability is likely to remain a central topic of political debate in the coming months. The expiration of ACA subsidies will likely intensify calls for legislative action to address the problem. Potential solutions could include expanding subsidies, negotiating lower drug prices, and implementing policies to control hospital costs. Ongoing monitoring of health expenditure data by organizations like CMS and KFF will be crucial for informing policy decisions and tracking the effectiveness of any interventions. Further research is needed to understand the long-term consequences of delayed care and the impact of healthcare costs on individual and family well-being.