A new survey shows that nearly half of working-age Americans struggled to pay for their family’s healthcare in 2025. The high costs even forced 35% of people to leave their medical needs completely unmet.
The findings come from the Urban Institute, which analyzed data from more than 10,000 adults in December 2025. The research, funded by the Robert Wood Johnson Foundation, highlights how widespread the issue has become regardless of whether a person actually has health insurance.
While people without insurance faced the highest rate of financial difficulty at 60%, those with coverage were surprisingly close behind. More than half of the people who bought their own insurance (54%) or enrolled in Medicaid (57%) said they had a hard time affording care. Even among those who get their health insurance through an employer, 39% reported dealing with affordability challenges.
“Affordability of healthcare is everyone’s concern, not just people who are uninsured,” Katherine Hempstead, senior policy advisor at the Robert Wood Johnson Foundation, said. “In addition to rising premiums, higher out-of-pocket costs make many people less secure and potentially less healthy as they avoid needed care.”
The financial burden fell especially hard on people already dealing with medical problems. About 69% of adults with disabilities struggled to afford their care. That number stayed above 60% for people diagnosed with chronic conditions like cancer, diabetes, heart disease, stroke, or COPD.
Demographics and geography also played a clear role in the findings. Over half of Black and Hispanic adults, rural residents, and people living in the southern United States reported difficulty paying for their families’ medical needs last year.
When families couldn’t afford care, the most common result was simply going without it. For others, it meant taking on financial baggage. Just under 30% of the surveyed adults said their family had to go into debt just to pay their medical bills.
Researchers warn that the situation might get worse for working families in the near future. They point to the recent expiration of enhanced premium tax credits, which has already pushed up premiums and deductibles for people buying ACA Marketplace plans. They also noted that federally mandated Medicaid and Marketplace policies are projected to leave millions more without insurance.
“These findings highlight widespread difficulty in affording healthcare across the United States,” Michael Karpman, principal research associate at the Urban Institute, said. “Recent federal policy changes could exacerbate these difficulties by increasing the number of people who are uninsured. And if more employers shift the rising costs of healthcare to their employees, affordability challenges will increase.”
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