82 Million Americans Now Choose Between Medical Bills and Daily Life

West Health-Gallup Center on Healthcare in America

The number sounds too large to be real: 82 million. That is how many American adults report making at least one financial trade-off in the past year just to pay for healthcare, according to a nationally representative survey from the West Health-Gallup Center on Healthcare in America.

Among the most common sacrifices: 15% of respondents said they rationed or skipped prescriptions, and another 15% borrowed money. These are not hypothetical hardships. They are choices made by real people weighing a pharmacy bill against an electricity bill.

The squeeze reaches six-figure households

The heaviest burden falls where you would expect. Among households earning under $24,000 a year, 55% reported trade-offs. Among the uninsured, 62% did. But the data punctures any assumption that this is solely a low-income problem. A quarter of adults in households earning $90,000 to $120,000 reported the same kinds of sacrifices. Even among those earning $240,000 or more, 11% said they were making trade-offs to cover medical expenses.

The survey, conducted by web from June through August 2025, drew on responses from 19,535 adults across all 50 states and Washington, D.C. At a 95% confidence interval, the margin of error is plus or minus 1.3 percentage points for national results. This is not a small poll with a shaky sample - it is one of the larger healthcare affordability surveys conducted in recent years.

Life decisions on hold

A second West Health-Gallup survey, conducted from October through December 2025 with 5,660 adults, paints an even starker picture. Healthcare costs are not just straining monthly budgets. They are reshaping the arc of people's lives.

Twenty-six percent of respondents said they delayed surgical or medical treatments. Eighteen percent postponed changing jobs. Fourteen percent put off buying a home. Nine percent delayed retirement. And 6% said they postponed having or adopting a child.

Even among households earning $180,000 to $240,000, 34% reported delaying at least one major life decision in the past four years. Among those who describe healthcare costs as a major financial burden, 78% said they had postponed at least one such decision.

From budgeting problem to systems failure

The sheer breadth of the findings challenges easy explanations. When families earning well into six figures are putting off home purchases and medical procedures because of healthcare expenses, the problem is structural, not personal.

Tim Lash, President of the West Health Policy Center, framed it in systemic terms, noting that when families across every income level are forced to choose between medical bills and heating, that represents a systems failure rather than a personal budgeting problem.

Joe Daly, Global Managing Partner at Gallup, pointed to the relationship between healthcare affordability and long-term life planning, noting that the data offers measurable insight into how cost pressures within the healthcare system influence broader financial decisions.

The concern levels are climbing. A previous release from the same survey found that 47% of U.S. adults worried they would not be able to afford necessary healthcare in 2026 - the highest level of concern since West Health and Gallup began tracking in 2021.

Prescription rationing is not a fringe behavior

Perhaps the most medically alarming finding is the 15% who reported rationing or not adhering to prescriptions. Medication non-adherence is well-documented as a driver of emergency hospitalizations, disease progression, and preventable deaths. When one in seven adults is stretching or skipping medications to save money, the downstream costs to the healthcare system - in emergency visits, complications, and lost productivity - likely dwarf the savings patients are attempting to achieve.

The borrowing figure is equally telling. Another 15% said they took on debt to pay for healthcare. In an environment of elevated interest rates, medical debt compounds quickly and can spiral into credit damage, bankruptcy filings, and long-term financial instability.

What the numbers do not capture

The survey has real limitations worth noting. It was conducted entirely online and in English, meaning adults without internet access or English fluency were excluded. Given that these populations often face the most severe healthcare access barriers, the survey may actually undercount the problem.

The data is also self-reported. People may underestimate or overestimate their trade-offs depending on how they frame their own financial decisions. And while the survey captures what people say they are doing, it does not measure the health consequences of those choices - the worsened conditions from skipped medications, the untreated injuries from delayed surgeries.

The second survey, with a smaller sample of 5,660, carries a wider margin of error of plus or minus 2.1 percentage points, and its questions about life decisions over the past four years introduce recall bias.

A chronic condition with no clear treatment

Healthcare affordability in the United States has been deteriorating for years, and these findings confirm the trend is accelerating. The fact that concern about affording care in 2026 hit a five-year high even before this year began suggests the pressure is building, not easing.

What makes these results particularly difficult is their universality. This is not a problem confined to the uninsured or the unemployed. It reaches into households that, by most measures, should be financially secure. When a quarter of families earning $240,000 or more report postponing major life events because of healthcare costs, the problem has outgrown any targeted policy fix.

The question is no longer whether healthcare costs are affecting American life. The data makes that clear. The question is how long a system can sustain this level of strain before the trade-offs become irreversible.