Medical debt is leading millions of Americans, many of whom are insured, to borrow money. (© spyrakot – stock.adobe.com)

By nearly every measure, America’s healthcare affordability crisis is worsening, with vulnerable populations bearing the brunt of rising costs and diminishing access.

WASHINGTON — New research reveals a troubling trend: nearly 29 million U.S. adults now report being unable to afford or access quality healthcare, marking the worst levels since researchers began tracking this data in 2021.

A survey by West Health and Gallup shows that 11% of Americans are now classified as “Cost Desperate” – unable to access quality healthcare and recently struggling to pay for needed care or medicine. This represents a 3% increase since 2021, but the national average masks far worse conditions facing specific groups.

The data shows Hispanic adults have been hit hardest, with 18% now categorized as Cost Desperate – an 8% jump since 2021. Black adults follow closely with 14% (up 5% since 2021), while White adults remain at 8%, virtually unchanged over the same period.

Families with the lowest incomes face the bleakest situation. Among households earning less than $24,000 yearly, a quarter now fall into the Cost Desperate category – an 11% increase since tracking began. This means one in four of America’s poorest citizens consistently can’t access or afford basic healthcare.

The researchers note various factors contributing to this divide, including rising medical costs, persistent drug shortages, increasing Medicaid disenrollment, and major cuts to the Children’s Health Insurance Program.

Security Continues to Erode

The survey also tracks those considered “Cost Secure” – Americans who both have access to quality, affordable care and can pay for needed treatments and medications. Only 51% of Americans now fall into this category – the lowest level recorded in the study’s history.

Hispanic adults have seen their healthcare security collapse, with only 34% now considered Cost Secure – down 17% since 2021. Black adults have experienced a 13% drop to 41%. Meanwhile, White Americans have maintained their stability at 58%.

Lower-income households have experienced similar devastating drops in healthcare security. Among those earning under $24,000 annually, only 23% qualify as Cost Secure – a 14% drop since 2021. For households in the $24,000-$48,000 range, just 30% maintain stable healthcare access and affordability (down 12% since 2021).

The remaining 38% of Americans fall into the middle “Cost Insecure” category – experiencing occasional difficulty with healthcare costs or access. Black (45%) and Hispanic (48%) adults are much more likely than White Americans (34%) to occupy this precarious middle ground.

Healthcare Access Problems Worsen

More than one-third of Americans (35%) report being unable to access quality, affordable healthcare – up 4% from 2023 and 6% since 2021.

The situation is particularly dire for lower-income households. Among those earning under $24,000 annually, 64% cannot access affordable, quality healthcare – an 11% jump in just one year. Those in the next income bracket ($24,000-$48,000) face similar challenges, with 57% reporting inability to access affordable care – a 12% increase since 2023.

Meanwhile, households earning $120,000 or more report no meaningful change in their healthcare access since 2023, widening the gap between economic classes to unprecedented levels.

Age remains a key factor in healthcare affordability. Only 4% of Americans aged 65 and above are considered Cost Desperate – up just 1% since 2021. By comparison, rates have risen 3% among those aged 50-64 (now 11%) and 4% among those younger than 50 (now 14%).

Real Human Costs

These statistics translate to real hardships for American families. Recent supplementary research from West Health and Gallup shows that 12% of adults borrowed money to pay for healthcare last year, amounting to an estimated $74 billion in medical debt nationwide.

Nearly 60% of Americans worry about going into debt from a major medical event. Many report cutting spending on necessities like food and utilities to pay for care, and others stay in unwanted jobs solely for health benefits.

The research suggests the healthcare system is increasingly divided – reliable care for those with financial resources, and an unstable patchwork system for those without. Without intervention, this healthcare divide will likely continue growing.