Unsurprisingly, the financial strain is most prevalent among households earning under $24,000 a year (55%) and those without health insurance (62%). Nonetheless, a quarter of adults in households earning $90,000 to $120,000 a year (25%) say they too are making trade-offs, as are 11% in households earning $240,000 or more.
These are the latest findings from a nationally representative survey of nearly 20,000 U.S. adults conducted from June through August 2025 that previously found nearly half of U.S. adults (47%) saying they are worried they will not be able to afford necessary healthcare in 2026, the highest level of concern recorded since West Health and Gallup began tracking in 2021.
“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. That’s why West Health is partnering with policymakers and health system leaders to advance practical, scalable reforms that address the root causes of unaffordable care, not just the symptoms,” said Tim Lash, President, West Health Policy Center.
Americans Put Life on Hold Due to Healthcare Costs
In a separate West Health-Gallup survey of 5,660 U.S. adults conducted at the end of last year, millions of Americans revealed that they are delaying events such as surgical and medical treatments (26%), changing jobs (18%), or purchasing a new home (14%) due to healthcare cost pressures. Nearly one in 10 (9%) said they have postponed their retirement, and 6% have put off having or adopting a child.
“What stands out in these findings is the relationship between healthcare affordability and long-term life planning,” said Joe Daly, Global Managing Partner at Gallup. “The data offer measurable insight into how Americans are experiencing cost pressures within the healthcare system and how those experiences are influencing their broader financial decisions.”
About half of adults in households earning $48,000 to less than $180,000 annually report postponing at least one major life decision in the past four years. Even 34% of households earning $180,000 to less than $240,000 report delaying life events, as do one in four adults (25%) in households earning $240,000 or more.
Among those who describe healthcare costs as a “major financial burden,” 78% say they have postponed at least one life decision in recent years, compared with half (50%) of those who view costs as a minor burden and 20% of those who do not consider them a burden. Taken together, the results indicate that healthcare costs are affecting both immediate household stability and longer-term life planning for Americans nationwide.
Methodology
West Health-Gallup Center on Healthcare, June-August 2025
The West Health-Gallup State Survey was conducted by web June 9-Aug. 25, 2025, with a sample of 19,535 adults aged 18 and older residing in all 50 U.S. states and the District of Columbia. Gallup conducted the study by recruiting respondents via address-based sampling (ABS) methods and the Gallup Panel™, a nationally representative, probability-based panel of U.S. adults. Six states used the Gallup Panel sample only; the rest used a combination of Gallup Panel and ABS samples. All surveys were conducted as web surveys and in English. Respondents without internet access were not covered by this study. Gallup weighted the combined samples to correct for nonresponse. Nonresponse adjustments were made by adjusting the sample to match the national demographics of gender, age, race, Hispanic ethnicity, education and region. Demographic weighting targets were based on the most recent Current Population Survey figures for the aged 18 and older U.S. population. For results based on the full sample, the design-effect-adjusted margin of error (MOE) at the 95% confidence interval is ±1.3 percentage points for response percentages around 50%. The margin of error for state-level data is ±5.4 to ±8.1 percentage points for response percentages around 50%.
West Health-Gallup Center on Healthcare, October-December 2025
Results are based on a Gallup Panel study conducted Oct. 27-Dec. 22, 2025, with a sample of 5,660 adults aged 18 and older who are members of the Gallup Panel, a nationally representative, probability-based panel of U.S. adults. Gallup uses random selection methods to recruit Panel members, including random-digit-dial (RDD) phone interviews that cover landlines and cellphones and address-based sampling (ABS) methods. Respondents with internet access completed the questionnaire as a web survey, and those without regular internet access were sent a printed questionnaire to complete and return by mail. The sample for this study was weighted to be demographically representative of the U.S. adult population, using the most recent Current Population Survey figures. For results based on this sample, one can say that the maximum margin of sampling error is ±2.1 percentage points at the 95% confidence level. Margins of error are higher for subsamples. In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error and bias into the findings of public opinion polls.
About the West Health-Gallup Center on Healthcare in America
The Center on Healthcare in America is a joint initiative from West Health and Gallup dedicated to elevating the voices and experiences of Americans within the healthcare system. Through rigorous research and human-centered storytelling, the Center aims to drive actionable insights and inform policy solutions nationwide. Visit www.westhealth.gallup.com.
About West Health
Solely funded by philanthropists Gary and Mary West, West Health is a family of nonprofit and nonpartisan organizations that include the Gary and Mary West Foundation and Gary and Mary West Health Institute in San Diego and the Gary and Mary West Health Policy Center in Washington, D.C. West Health is dedicated to lowering healthcare costs to enable seniors to successfully age in place with access to high-quality and affordable health and support services that preserve and protect their dignity, quality of life and independence. Learn more at westhealth.org.
About Gallup
Gallup delivers analytics and advice to help leaders and organizations solve their most pressing problems. Combining 90 years of experience with its global reach, Gallup knows more about the attitudes and behaviors of employees, customers, students and citizens than any other organization in the world.
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