WASHINGTON — The West Health-Gallup Affordability Index released its 2025 survey findings, indicating a decline in the percentage of U.S. adults categorized as cost secure. In 2025, 49 percent of adults were identified as cost secure, a classification for individuals with access to high-quality affordable care who recently could afford needed care and medicine.

This figure marks a decrease from previous years, where 56 percent of adults were cost secure in 2021, rising to 61 percent in 2022 before beginning an annual decline. Approximately three-quarters of respondents reported that healthcare costs imposed a major or minor financial burden on their family. Half of the respondents also expressed concern about their household's ability to pay for needed healthcare services in 2026, which is an increase from 42 percent in 2022.

The survey further revealed demographic disparities. About 33 percent of adults under age 30 were categorized as cost secure in 2025, down from 46 percent in 2021. The 2025 survey showed 57 percent of men were cost secure compared to 42 percent of women. For older Americans, the percentage of those categorized as cost secure dropped from 73 percent in 2021 to 61 percent in 2025.

More than half of those surveyed indicated that healthcare costs contribute to their daily stress. About 20 percent of adults reported being unable to pay for a prescribed medication within the three months prior to the survey due to cost. Additionally, about 30 percent of respondents forewent medical treatment for a health problem due to the expense.

Twannetta Weaver, a 43-year-old Florida resident, delayed her graduation with a leadership degree by one year after incurring medical bills in 2025 for a slipped disk. Weaver said. "It makes you feel powerless as a consumer."

Xavier Chapa, a 55-year-old Arizona resident, relocated to the U.S. from Europe three years ago. His 50-year-old wife was denied insurance coverage for a preventive colonoscopy despite a prior verbal assurance that the procedure would be covered. Chapa reduced his 8-year-old son's summer camp schedule from full-day to half-day programs due to a projected $3,000 medical bill. "What point does it serve if you're living in this country and having to pay such a high price and you can't get some of the basic things?" Chapa said.

Inger Perez, a 59-year-old Texas resident, chose a lower-cost Affordable Care Act marketplace plan with a limited provider network. Her family has a history of diabetes, high blood pressure, and cancer. Perez lives in a rural area approximately one hour from a doctor's office. Perez said. "I'm terrified that I'll start a plan of treatment but won't be able to afford to keep up with it." The West Health-Gallup Affordability Index surveyed 5,660 adults from October 27 to December 22, 2025, with a margin of sampling error of plus or minus 2.1 percentage points.