Gallup: Healthcare Unaffordable for Over 50% of Americans as Premiums Surge 58%

For health policy and IT leaders, the new Gallup data is a flashing red light: fewer than half of Americans can comfortably afford healthcare, an all-time low. This crisis is compounded by the expiration of enhanced ACA subsidies, which Democrats say has caused a 58% premium spike, pushing over 1 million people off coverage and accelerating hospital closures. The findings demand a reexamination of how cost transparency, telehealth, and value-based care tools can bridge the growing affordability gap.

For the first time since tracking began, fewer than half of Americans can comfortably afford healthcare, according to new Gallup data released on June 22, 2026. The survey, fielded before the recent expiration of enhanced Affordable Care Act (ACA) subsidies, underscores a deepening affordability crisis amid rising insurance premiums, drug prices, and Medicaid cuts. Nearly three-quarters of U.S. adults said healthcare costs are a financial burden, and half are concerned they will be unable to pay for necessary care in the coming year. These findings reflect the cumulative impact of policy decisions and market dynamics that have intensified financial strain on households across income levels.

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The Administration’s broader healthcare agenda includes nearly $1 trillion in Medicaid cuts over a decade, projected by the Congressional Budget Office to leave an additional 15 million people uninsured.

The expiration of the enhanced ACA tax credits — which Democrats say occurred after President Trump and Republicans refused an extension — has been a pivotal shock. According to the Democratic Party, insurance premiums for marketplace plans increased by an average of 58%, triggering an initial enrollment decline of over 1 million people. While these figures come from a political source, the Gallup data predates this policy shift, indicating that affordability was already at crisis levels. The Administration’s broader healthcare agenda includes nearly $1 trillion in Medicaid cuts over a decade, projected by the Congressional Budget Office to leave an additional 15 million people uninsured. Hospital and provider closures have mounted, with over 1,000 facilities shutting down or reducing services, further eroding access to care.

Rising drug prices compound the problem. Pharmaceutical companies have launched new brand-name drugs at an average annual price of $353,000 and have raised existing drug prices on hundreds of products, despite Trump’s “most favored nation” executive orders intended to lower drug costs. These price hikes amplify out-of-pocket expenses for patients, particularly those in high-deductible plans or without insurance.

The public health implications are stark. The unaffordability crisis is not limited to the uninsured; even insured Americans are struggling. About half of respondents expressed extreme concern about affording necessary healthcare over the next year. This fear of medical bills often leads to delayed or forgone care, worsening chronic conditions and increasing emergency-room utilization, which in turn drives up system costs. Additionally, the closure of hospitals, nursing homes, and maternity wards in rural and underserved communities creates “healthcare deserts,” forcing patients to travel long distances for basic services.

The midterm election landscape is being shaped by healthcare affordability. Nearly half of Americans say they are more likely to vote for candidates who support reinstating the enhanced ACA subsidies. Democrats have seized on the issue, framing the affordability decline as a direct result of GOP policies. Meanwhile, the Trump administration has floated proposals to allow Americans to take out loans for medical debt, a move critics say would deepen the financial vulnerability of patients. The healthcare industry is bracing for further upheaval: insurers face enrollment losses and adverse selection if younger, healthier people drop coverage due to unaffordable premiums, while providers contend with rising uncompensated care.

Without legislative intervention, the affordability trajectory is likely to worsen. The Medicaid cuts, phased in through block grants or per capita caps, would disproportionately affect low-income families, children, and the elderly. Drug pricing remains a battleground, with the administration’s piecemeal approach showing limited effect on launch prices. The upcoming midterms could be a referendum on healthcare policy, determining whether the enhanced subsidies are restored or permanent structural changes are enacted. For now, the data serves as a stark warning: the American healthcare system’s cost burden has reached a breaking point, with profound implications for population health and economic stability.

The Gallup survey, which has tracked healthcare affordability since 2018, hit a new low, with only about 48% of U.S. adults reporting they can comfortably afford healthcare. This decline cuts across income levels, though lower-income households are hardest hit. The fear of medical bills is pervasive: 50% of American households worry they cannot pay for needed care in the next 12 months, according to the survey. These findings emerge even before the full impact of the 2025-2026 policy shifts is realized.

If accurate, the premium surge would mean the uninsured rate, which had reached a record low under the enhanced subsidies, is climbing again. Already, the strain on providers is visible. Pharmaceutical costs continue to climb. Despite the administration’s drug pricing model, manufacturers have raised prices on hundreds of existing drugs and set launch prices for new therapies at an average of $353,000 annually. The policy has not curbed list prices, and insurers pass these costs to consumers through higher deductibles and copayments.