With the specter of possible federal cuts to Medicare and Medicaid, the percentage of Americans who can afford and access prescription drugs and quality healthcare has already hit a new low of 55%, a six-point decline since 2022. And, more than 31 million Americans (12%) report needed to borrow a combined $74 billion during 2024 to pay for healthcare despite most having some form of health insurance.
Data in research for the West Health-Gallup Healthcare Affordability Index show the downturn is largely attributed to two groups — adults age 50 to 64 (down eight points to 55%) and those age 65 and older (down eight points to 71%), a troubling sign since Medicare eligibility for most Americans begins at 65. The percentage of adults younger than 50 who could readily afford healthcare was the lowest of any age group at 47%, a five-point decline since 2022.
An estimated 72.2 million — roughly one in three — American adults did not seek needed healthcare in the prior three months due to cost, including an estimated 8.1 million Americans age 65 and older. Nearly one-third (31%) were concerned about their ability to pay for prescription drugs during the next 12 months, up from 25% in 2022.
“Healthcare affordability in America is headed in the wrong direction,” Timothy Lash, president, West Health, a nonprofit focused on aging and healthcare research, policy and philanthropy, said via a statement. “The good news is that healthcare 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.”
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.
Researchers grouped Americans into one of 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 healthcare and prescriptions;
- Cost Insecure: Recently unable to either pay for care or medicine or unable to access it; and,
- Cost Desperate: Recently unable to pay for care and medicine and lack immediate access to quality care.
Nearly half (45%) 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 data shows. The percentage of people age 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%).
“The year 2022 showed encouraging trends of increased healthcare affordability post-pandemic,” Dan Witters, senior researcher at Gallup said via a ststement. “The decline in 2024 is concerning in that it shows the fragility of Americans’ purchasing power amid a high-priced healthcare 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.”
The West Health-Gallup data confirms what many hospitals and health systems have been seeing firsthand, according to Alice Ayres, president and CEO of the Association for Healthcare Philanthropy. “Healthcare affordability in America is at a crisis point. With nearly half of U.S. adults struggling to pay for medical care, and millions avoiding necessary treatment due to cost, philanthropy must — and will –step up. But it cannot and should not replace public funding,” she said. “If Medicare and Medicaid cuts proceed, we will see even greater financial strain on families and an increased reliance on philanthropic support. This is not sustainable. Philanthropy has a role to play in supporting the health of our communities, but systemic solutions are critical to reversing these troubling trends.”
