New figures reveal more Americans struggling to afford health care

The percentage of Americans who can afford and access prescription drugs and quality health care stands at a new low of 55%, a six-point decline since 2022, according to the West Health-Gallup Healthcare Affordability Index. The index was developed in 2021 to track the percentage of Americans who say they have avoided medical care or not filled prescription medications in the last three months and whether they believe they could afford care if they needed it today.

The downturn is largely attributed to two groups—adults aged 50 to 64 (down eight points to 55%) and those aged 65 and older (down eight points to 71%), a troubling sign since Medicare eligibility for most Americans begins at 65. The percentage of adults under 50 who could readily afford health care was the lowest of any age group at 47%, a five-point decline since 2022.

For the index, researchers grouped Americans into one of the following three categories depending on how they reported their ease or difficulty paying for and accessing medical care, including prescribed drugs:

• Cost-secure—no recent problems with affording and accessing health care and prescriptions;
• Cost-insecure—recently unable to either pay for care or medicine or unable to access it;
• Cost-desperate—recently unable to pay for care and medicine and lack immediate access to quality care.

“After an uptick in 2022, health care affordability in America is headed in the wrong direction,” said Timothy Lash, President, West Health, a nonprofit focused on aging and health care research, policy and philanthropy. “The good news is that health care provisions in the Inflation Reduction Act—including empowering Medicare to negotiate lower drug prices, which has not yet taken effect—may help slow these negative trends and provide more stability. But much more must be done to rein in prices for Americans of all ages. High prices are one of the biggest impediments to a healthy aging population and a prosperous economy.”

Forty-five percent of American adults report struggling to cover their medical bills and are either cost-insecure or cost-desperate. Younger adults are more than three times as likely to be cost-desperate than those 65 and older (10% vs. 3%). The percentage of people aged 50 to 64 years old considered cost-desperate has risen to 10%, the highest level measured for this group so far. Racial and gender divides have also widened, with Black (11%) and Hispanic (14%) adults considerably more likely to fall in the cost-desperate category than their white counterparts (7%) and women (11%) nearly twice as likely as men (6%).

According to the recently released West Health-Gallup 2024 Survey on Aging in America, an estimated 72.2 million—or nearly one in three—American adults did not seek needed health care in the prior three months due to cost, including an estimated 8.1 million Americans aged 65 and older. Nearly one-third (31%) were concerned about their ability to pay for prescription drugs in the next 12 months, up from 25% in 2022.

“The year 2022 showed encouraging trends of increased health care affordability post-pandemic,” says Dan Witters, Senior Researcher at Gallup. “The decline in 2024 is concerning in that it shows the fragility of Americans’ purchasing power amid a high-priced health care system. In a relatively short time, many adults have gone from feeling confident they can cover their health costs to struggling to cover their medical bills.”

In addition to the index on affordability, a West Health-Gallup Health care Value Index was developed in 2021 to track public sentiment as to the perceived worth of the medical care Americans receive relative to the amount they pay. This index provided one of the few slightly positive trends. Though more than a third (36%) of Americans in 2024 believe that they—and Americans generally—are paying too much for the quality of care they receive and that their most recent care experience was not worth the cost, this is nine percentage points less than was reported three years ago.

Methodology

Results are based on a survey conducted by both mail (focused on older Americans) and web from Nov. 13, 2023, to Jan. 8, 2024, with 5,149 adults aged 18 and older, living in all 50 U.S. states and the District of Columbia as a part of the Gallup Panel.

For results based on these monthly samples of national adults, the margin of sampling error at the 95% confidence level is ±1.7 percentage points for response percentages around 50% and is ±1 percentage point for response percentages around 10% or 90%, design effect included. For reported age subgroups, the margin of error will be larger, typically ranging from ±3 to ±5 percentage points.

Provided by
West Health Institute