Editor's Note: The following study was conducted in a partnership between West Health and Gallup.
WASHINGTON, DC – The percentage of US adults who have not afforded or had no access to high-quality healthcare recently reached 11%, the highest level since 2021.
The most notable increase since 2021 occurs among Hispanic adults (up 8% to 18%), black adults (up 5 points to 14%) and lowest-income households, earning under $24,000 a year (up 11 points to 25%). On the other hand, there was no meaningful change in the proportion of white or middle-income individuals facing the same level of struggle. As a result, disparities in access to healthcare based on race, ethnicity and income are also at their highest point since surveying began.
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Compared to 2021, the proportion of Americans over the age of 65 is considered hopeless in costs by just one point in 2024, up 4% of people aged 50-64 (currently 11%), and 4 points (currently 14%) of people under the age of 50 (currently 14%).
West Health and Gallup have developed an affordable healthcare index to track access and affordability to American healthcare. Research found that people can categorize into one of three categories based on the following criteria:
Cost-safe individuals have access to quality, affordable care and can pay for the care and medication they need. Cost unstable individuals either lack access to quality, affordable care, or have recently been unable to pay for either the care or medication they need. Cost-desperate individuals lack access to quality affordable care and have recently been unable to pay for the care and medication they need.
The most recent findings come from the West Health-Gallup Healthcare Indices Study, conducted using web and email surveys from November 18th to December. 27, 2024. This study included a nationally representative sample of 6,296 adults aged 18 and older via the Gallup panel.
The gaps spread between what you have and what you don't have
The Cost Desperate category is still at its highest level, but the percentage of adults classified as cost-safe is at the lowest level that can access and provide high-quality healthcare, only about half (51%) of Americans falling into this category.
The demographic groups that saw the biggest decline were Hispanic adults (34%, down 17 points) and black adults (41%, down 13 points). Meanwhile, the proportion of white adults classified as cost safety (58%) is consistent with the 2021 level, further indicating a widening racial/ethnic gap in access to high-quality, affordable healthcare.
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Double digit declines are also seen among Americans in the lowest-income households. Of those living in households earning less than $24,000 a year, the safest proportion has fallen 14 percentage points since 2021 to 23%. A similar decline of 12 points to 30% is evident in households that range from $24,000 to $48,000 a year.
In recent years, there has been a significant change in the proportion of Americans classified as hopeless and expensive, but nearly four in ten people do not cost anything.
Similar race-income gaps are evident among these cost-unstable Americans. Black (45%) and Hispanic (48%) adults are much more likely to fall into this category, much higher than white Americans (34%), as are Americans who earn less than $48,000 a year, with more than half of them being considered cost-unstable.
1 in 3 adults who don't have access to affordable, high quality healthcare
One of the three metrics that make up an affordable index is access to affordable quality care when needed. Over a third (35%) of Americans report having no access to quality, affordable healthcare since 2023.
Although households under $48,000 per year have always reported difficulty accessing affordable healthcare, the challenges have been significantly worsening over the past year, with 12 points (57%) of households under $24,000 reaching under $48,000.
Adults in high-income households (who make more than $120,000) have not reported any changes to this aspect of the healthcare affordability index since 2023. As such, the already large gap between high-income and low-income Americans in their ability to access affordable care has now grown to the widest levels.
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meaning
Erosion of cost security in healthcare has serious practical consequences for the American public. A recent survey by West Health and Gallup found that 12% of US adults borrowed money to borrow money from healthcare last year, representing an estimated $74 billion in borrowing, and nearly 60% of US adults feel “somewhat” or “very” concerned they'll end up in debt due to major medical events. Other common effects of affordability include significant stress for household members, reducing spending on basic items such as food, transportation, and utilities, reducing care payments, and staying in undesirable jobs just for health benefits. The rate of growth in costs for the US is another reflection of the financial tension and real anxiety experienced by US healthcare consumers
The increase in the proportion of Americans who can't afford medical or medicine has disproportionately affected Black, Hispanic, and low-income families over the past year, revealing that the already-existing and already-existing gaps in providing care are greater than ever. These changes may reflect the confluence of factors, such as rising levels of consumer and healthcare inflation, sustained drug shortages, and the rate of Medicaid removal due to ongoing expiration of registration clauses and massive reductions in enrollment for the Pediatric Health Insurance Program (CHIP) program.
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