Nearly Half of US Adults Struggled to Afford Healthcare in 2025, Study Shows
New Urban Institute study reveals widespread healthcare affordability crisis affecting Americans regardless of insurance status.
NASHVILLE, TENNESSEE — Forty-six percent of U.S. adults reported struggling to afford healthcare in 2025, regardless of their insurance coverage, according to a new report from the Urban Institute released Wednesday.
The nonprofit research think tank analyzed results from a December 2025 survey of 10,000 working-age adults nationwide. The Robert Wood Johnson Foundation funded the research, which comes amid ongoing cost-of-living concerns and economic challenges facing American families.
Insurance Coverage Doesn’t Guarantee Affordability
Even adults with insurance faced significant financial barriers to healthcare access. Nearly 40 percent of adults with private employer coverage reported affordability problems, while roughly 54 percent of those with Marketplace plans experienced similar challenges.
Adults enrolled in Medicaid fared slightly worse, with 57 percent reporting difficulties affording medical care. Uninsured adults faced the greatest burden, with 60 percent experiencing at least one affordability problem.
Researchers defined affordability challenges as trouble paying family medical bills in the past year, a family member not receiving needed healthcare due to costs, or the family carrying medical debt at the time of the survey.
Widespread Unmet Healthcare Needs
More than one-third of all surveyed adults — approximately 35 percent — said a family member had unmet healthcare needs because of costs. This finding highlights how financial barriers prevent Americans from accessing necessary medical care.
The survey revealed stark disparities in healthcare affordability across different demographic groups. Adults with disabilities were significantly more likely to struggle with healthcare costs, with almost 69 percent reporting affordability problems compared to 40 percent of adults without disabilities.
Racial and Health-Related Disparities
The study found significant racial disparities in healthcare affordability. The majority of Black and Hispanic adults reported struggling to afford care, compared with about 42 percent of white adults and 28 percent of Asian adults.
Specific health conditions also correlated with affordability troubles. More than seven in 10 people who suffered strokes reported problems affording care for their families. Adults with COPD, chronic bronchitis or emphysema followed closely at 70 percent, while approximately 64 percent of those with cancer and heart disease faced similar challenges.
Geographic location played a role in healthcare affordability as well. Half of adults living in the South — a region that includes several states that haven’t expanded Medicaid eligibility — and those in rural areas reported affordability challenges.
The findings highlight ongoing barriers to healthcare access in the United States, despite various insurance coverage options available to working-age adults.
