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Rising Concerns Over Future of Medicare and Social Security

Rising Concerns Over Future of Medicare and Social Security

Editor's Note: The research detailed below was conducted in partnership with West Health, a family of nonprofit and nonpartisan organizations focused on lowering healthcare costs to enable successful aging.

WASHINGTON, D.C. -- Seventy-three percent of U.S. adults under the age of 65 report that they are “worried” (41%) or “extremely worried” (32%) that Medicare will not be available when they are eligible to receive it, a six-percentage-point jump since 2022, according to a new study by West Health and Gallup. The increase in concern is sharpest among those aged 50 to 64 (up 13 points to 74%) and 40 to 49 (up nine points to 83%, the highest level of all age groups).

Worries over Social Security are even higher and have also grown significantly -- 80% of respondents report that they are worried (33%) or extremely worried (47%), compared with 75% in 2022. Among those aged 50 to 61 -- the group closest to being eligible for Social Security -- 81% are now worried, compared with 72% in 2022, a nine-point increase.


The West Health-Gallup 2024 Survey on Aging in America was conducted by web and mail Nov. 13, 2023-Jan. 8, 2024, with 5,149 adults aged 18 and older, living in all 50 U.S. states and the District of Columbia as a part of the Gallup Panel.

Full results from the new study can be found in the West Health-Gallup 2024 Survey on Aging in America report, which provides a comprehensive look at Americans’ changing attitudes, behaviors and trends related to growing older, with a special emphasis on healthcare and safety net programs.

Older Americans More Supportive of Safeguarding Medicare, Social Security

Older Americans are more likely than their younger counterparts to believe that ensuring the future viability of Social Security and Medicare is important, with 87% of those aged 65 or older assigning the “highest priority” to these programs, double the level found among 18- to 29-year-olds. Americans count on these programs being available to them when they are eligible to receive them, which in most cases is 65 for Medicare and 62 for Social Security.

Overall, 87% of adults under 65 believe Medicare will be “extremely important” or “important” to them in their later years, slightly higher than the 83% (under the age of 62) who say the same about Social Security. Among those under the age of 65 (for Medicare) and under the age of 62 (for Social Security), the level of importance of these programs grows even higher -- to 94% and 91%, respectively.

Issues Related to Aging Play Role in Voting Preferences

Nearly six in 10 Americans report they are “somewhat more likely” (37%) or “much more likely” (20%) to support a candidate for public office who makes issues affecting older Americans a top priority. This sentiment is more widespread for older people, peaking at 77% among those aged 65 and above.


However, most Americans don’t see the interests of older adults being addressed by political candidates. Nearly three-quarters of adults (73%) report that the government currently prioritizes these issues “not too much” (60%) or “not at all” (13%). This swells to 80% among those aged 65 and above.


Just 15% of adults, in turn, “strongly” or “somewhat” agree that the U.S. is prepared to care for its aging population, exposing little public confidence in the steps currently being taken.

Aging in America: Other Key Report Findings

Additional key findings from the West Health-Gallup 2024 Survey on Aging in America include:

Pessimism About Growing Older Runs Deep

  • While Americans are more likely to say their current lives are better, not worse, than their parents’ lives at the same age across many aspects of life, pessimism runs deep for the prospects of future generations. Over half think future generations will be worse off when it comes to mental health/happiness, financial security and stress levels, compared with under 20% who think future generations will be better off for each condition.

Healthcare Affordability Plays Central Role in Aging Successfully

  • Healthcare and prescription-drug costs continue to weigh heavily on American adults, with an estimated 49 million -- including 7.5 million aged 65 or older with Medicare -- who consider the cost of healthcare a “major burden.”
  • Nearly one-third (31%) say they are “concerned” or “extremely concerned” about their ability to pay for prescription drugs in the next 12 months, up significantly from 25% in 2022. Among older Americans aged 65 and above, the increase -- 11 points, from 20% to 31% -- is even greater, and is now equal to the level of concern among Americans aged 18 to 64.
  • High costs kept an estimated 72.2 million Americans from seeking treatment for needed care in the past three months, including 8.1 million aged 65 and older. For prescription medicines specifically, these estimates are 38.7 and 5.8 million, respectively.

Mental and Behavioral Health Challenges Getting Worse and Lacking Attention

  • Mental health challenges emerge as a key issue for Americans, including older adults. Over one-quarter (27%) of Americans aged 50 to 64 report that their mental health has worsened over the past three years, surpassing the percentage who report improvement (22%). Likewise, among those aged 65 or older, more report that their mental health has worsened (21%) than improved (17%).
  • Nine in 10 Americans (89%) think mental health is at least as important as physical health.


Medicare and Social Security are safety net programs that most Americans feel strongly about and rely on for their basic medical and financial needs as they grow older. Because the large majority of older Americans aged 65 and above are on Medicare, they are less likely to have issues with affordability and access than their younger counterparts. The younger group includes people on private insurance, Medicaid or other government insurance programs, such as those for military personnel or who have no insurance at all.

However, Americans -- particularly those closer being eligible to receive such programs -- are not taking for granted that Medicare and Social Security will always be there for them. Worries over these programs' solvency have risen most since 2022 among these groups.

These worries, along with U.S. adults’ general observation that issues affecting older Americans are not a high government priority, underscore the extent to which such issues could influence voting preferences -- notably among older voters, who typically vote at high rates. For elected officials, such sentiment could serve as a wake-up call to action.

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