Americans’ top health care concern is affordability as new survey finds nearly half worry about costs heading into 2026

Nearly half of Americans expressed concern about affording health care in 2026, according to a March 2026 West Health–Gallup survey released Thursday. The poll found that 29% of U.S. adults named cost as the most urgent health problem, the highest level in more than two decades, reflecting widespread anxiety tied to rising prescription drug prices and expiring ACA subsidies.

This represents a significant increase from 23% in 2025. Cost concerns outpaced other issues such as access to health care, cited by 17%, and obesity, mentioned by 8%, according to Gallup.

The West Health–Gallup survey found that 29% of U.S. adults identified health care costs as the most urgent health problem facing the country, the highest level recorded in more than two decades.

Nearly half of Americans, 47%, reported worry about their ability to afford health care in 2026, NBC News reported based on the same survey. The report linked this anxiety to rising prescription drug prices and the anticipated expiration of Affordable Care Act (ACA) subsidies. Concern over prescription drug costs has risen from 30% in 2021 to 37% in 2026, according to NBC News.

Gallup’s findings also show that seven in 10 Americans believe the U.S. health care system has major problems or worse. Within this group, 23% described the system as being in a state of crisis, a record high. Gallup indicated that the widespread concern about affordability reflects a broader negative perception of the health care system’s financial structure.

Additional polling underscores the prominence of affordability as a national issue. A March 31, 2026, summary by U.S. News reported that 61% of U.S. adults expressed a “great deal” of concern about health care accessibility and cost. The survey ranked health care as the foremost domestic issue, ahead of the economy, which was cited by nearly half of respondents. U.S. News noted that health care had held the top spot among American concerns from 2015 to 2020 before surging ahead by 10 points in 2026.

Data from the Kaiser Family Foundation (KFF) further illustrate the widespread burden of health care costs. KFF found that 44% of U.S. adults have difficulty affording health care, and 28% reported problems paying for care in the past 12 months. The foundation also reported that about two-thirds of adults are at least somewhat worried about affording care for themselves and their families. The financial strain is particularly acute among Hispanic adults, young adults, and the uninsured, KFF said.

Affordability issues are affecting health care behaviors and outcomes, according to an April 2026 survey by Imagine360. The survey found that 44% of respondents had skipped or postponed necessary care or medications due to cost. Among those who delayed care, 45% said their medical condition worsened. Additionally, 36% reported losing sleep over health care affordability during the past year, and 49% said they had cut back on essentials such as food, housing, and utilities to afford medical expenses.

Premium increases are adding to financial pressures. Polling by the PAN Foundation showed that 59% of Americans experienced higher health insurance premiums in 2026, with 41% reporting increases of 10% or more compared to the previous year. Premium hikes were especially common among people with Medicare (66%) and commercial insurance (69%). More than half of Americans, 54%, expressed concern about affording monthly premiums in 2026. Axios/Ipsos polling found that 69% of Americans worry insurance costs could rise, and majorities across political affiliations favor increased federal spending to reduce health care costs.

The growing concern over affordability comes as ACA subsidies are set to expire, potentially increasing out-of-pocket costs for many Americans. Policymakers are facing calls to address rising premiums and drug prices amid broad public frustration. The West Health–Gallup survey and other national polls suggest that health care affordability will be a central issue in the 2026 policy debate.