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Almost half of US consumers expect to have trouble paying healthcare bills in 2026

The data: 47% of US adults worry about how they’ll pay for necessary healthcare expenses next year, according to a West Health and Gallup study based on responses from 19,535 US adults from June to August.

  • 37% of respondents are concerned about prescription drug costs, up from 30% in 2021 when West and Gallup first began tracking the healthcare data.
  • In the past year, 30% of respondents skipped a test or procedure recommended by a physician due to cost.
  • 20% said they or a household member couldn’t afford to pay for prescription medications during the past three months.

Why it matters: Views on US healthcare affordability and access vary widely by state.

  • West and Gallup ranked all 50 states and Washington DC based on residents’ self-reported experiences on healthcare costs, quality and access. 29% of residents in the 10 bottom-ranked states say they couldn’t afford to pay for their prescription drugs compared with 15% of residents in the 10 top-ranked states.
  • Skipping recommended tests or procedures due to cost was most common in Mississippi (46%), one of the lowest-ranked states in the US, and least common in Massachusetts (18%), the second-highest ranked state.
  • Nationally, a majority (51%) of all US adults say it’s easy to access needed healthcare.
  • However, state-level access varied. 66% of respondents in Nebraska claimed easy access, compared with 30% of respondents in New Mexico and 31% in Nevada—two of the overall lowest-ranked states.

Implications for healthcare and pharma: Rising healthcare costs are changing consumer behavior as more people skip prescription medications and delay care because they can’t afford them. At the same time, healthcare affordability and access varies broadly by state, highlighting that healthcare experiences are being shaped as much by where people live as by national pricing trends.

Uneven access and affordability across the US points to an opportunity to engage consumers across different geographies, healthcare concerns, and social and financial realities. Healthcare marketers should use data-driven digital strategies like zip code targeting and AI to create hyperpersonalized content accordingly.

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