• Posted November 20, 2025

Nearly Half of Americans Fear They Can’t Afford Care in 2026, Poll Finds

Many Americans are bracing for higher medical costs in the new year and a growing number say those expenses are already shaping their decisions for care, according to a new survey.

The latest West Health–Gallup poll, shows that 47% of adults are worried they won’t be able to afford health care in 2026, the highest level since the organizations began tracking these concerns four years ago.

And 1 in 5 adults say someone in their household couldn’t pay for a prescription in the last three months.

The report, based on nearly 20,000 people across all 50 states, paints a detailed picture of how Americans experience cost, quality and access to care where they live.

Researchers ranked every state and the differences were striking.

States like Iowa and Massachusetts landed at the top for overall health care experience, performing well on cost, quality and access.

Meanwhile, states such as Alaska, Arkansas and Texas were among the lowest ranked, with residents reporting more difficulty finding care, paying for medications and accessing needed services.

Even in the best-performing states, many people still struggle.

In the top 10 states, 25% of adults say they skipped recommended care due to cost, compared with 40% in the lowest-ranked states. And 15% in top states couldn’t afford a prescription in the last three months, compared with 29% in bottom 10 states.

The survey also found that long wait times are a widespread barrier: 53% of Americans say delays prevented or postponed needed care. In Vermont, the rate reached 72%, while Nebraska, a top state for access, had 46% reporting this barrier.

Researchers say the findings highlight nationwide strain, even in states that perform well.

"Americans are saying, ‘Hey, now that I really think about it, I’m paying too much and I’m not getting enough,’" Timothy Lash, president of West Health, a nonprofit dedicated to lowering healthcare costs, said to NBC News. "Health care is not what it needs to be right now."

State gaps were also wide for prescription access, preventive care and finding providers. For example, 36% of adults in New Mexico said they didn’t know how to find a medical professional when needed, compared with 14% in Iowa, another top-ranked state for access, results show.

Overall, Americans gave the U.S. health care system a C grade, with D+ for cost and C+ for quality and access.

No states earned an A in any category.

Researchers say the results show that every state, even those near the top, has major room to improve.

More information

Gallup has the full poll results here.

SOURCES: Gallup, poll, Nov. 17, 2025; NBC News, Nov. 17, 2025