Editor's Note: The research detailed below was conducted in partnership with West Health, a family of nonprofit and nonpartisan organizations focused on healthcare and aging.
WASHINGTON, D.C. -- The percentage of U.S. adults readily able to access and afford quality healthcare when they need it has dropped six percentage points since 2022 to 55%, the lowest since West Health and Gallup began tracking healthcare affordability in 2021.
Although adults aged 50 and older are more likely than those younger than 50 to be “cost secure” -- meaning they have had no recent problems affording care or medicine and can easily access care -- their scores have fallen faster and further over the past two years. The percentages of cost secure adults aged 50 to 64 and 65 and older have both dropped eight points since 2022, to 55% and 71%, respectively. At the same time, the percentage of younger adults has slipped five points, from 52% to 47%.
The West Health-Gallup Healthcare Affordability Index is part of the West Health‑Gallup 2024 Survey on Aging in America, conducted by web and mail from Nov. 13, 2023, to Jan. 8, 2024, with 5,149 adults aged 18 and older, living in all 50 U.S. states and the District of Columbia, as part of the Gallup Panel™. The Healthcare Affordability Index determines affordability based on responses in three key areas:
- Care avoidance: Has there been a time in the last three months when you or a member of your household had a health problem, but you did not seek treatment due to the cost of care?
- Skipped treatments: Has there been a time in the last three months when you or a member of your household has been unable to pay for medicine or drugs that a doctor had prescribed for you because you did not have enough money to pay for them?
- Difficulty today: If you needed access to quality healthcare today, would you be able to afford it?
Based on these three metrics, researchers determined Americans fall into one of three categories of affordability:
- "Cost secure": Persons reporting no recent occurrences of a household member being unable to afford care or prescribed medicine and could afford quality healthcare if they needed it today.
- "Cost insecure": Persons reporting recent occurrences of being unable to pay for care or medicine or lacking easy access.
- "Cost desperate": Persons reporting recent occurrences of being unable to pay for care and prescribed medicine and saying they would not have access to affordable quality care if needed today.
Cost Desperate Levels Rise to New Highs for Black, Hispanic Adults
As the percentage of U.S. adults classified as cost secure has declined since 2022, the percentage classified as “cost desperate” is on the rise for Black and Hispanic adults and remains steady for White adults. Currently, 14% of Hispanic adults and 11% of Black adults meet the criteria for being cost desperate, compared with 7% of White adults, widening a previously existing race/ethnicity gap, particularly between White respondents and Hispanic respondents (6% and 11%, respectively, in 2022).
Significant Practical Implications Exist for Being Cost Desperate
There are substantial differences in healthcare and financial experiences and outcomes between those who are cost secure and those who are cost desperate. Compared with those who are cost secure, those categorized as cost desperate are:
- at least 10 times more likely to have cut back on utilities and food to pay for needed care in the past 12 months
- seven times more likely to have had a family member or friend die in the past 12 months after not receiving needed treatment due to an inability to pay for it
- 21 times more likely to be “extremely concerned” that their household will be unable to pay for needed prescription drugs in the next 12 months
- 29 times more likely to be “extremely concerned” that their household will be unable to pay for needed healthcare services in the next 12 months
Bottom Line
The decline since 2022 in the percentage of Americans categorized as cost secure is a troubling development made even more worrisome by steeper drops among Americans aged 50 and older, as well as Black and Hispanic adults.
According to the recently released West Health-Gallup 2024 Survey on Aging in America Report, an estimated 72.2 million people -- or about one in three U.S. adults -- did not seek needed healthcare in the prior three months due to cost, including 8.1 million Americans aged 65 and older. And nearly a third (31%), in turn, were concerned about their ability to pay for prescription drugs in the next 12 months, up from 25% in 2022.
After a modest upward trend in 2022, healthcare affordability is declining for more people.
For more content from West Health and Gallup, see the new West Health-Gallup Healthcare Affordability and Value Index report.
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