Every day, millions of Americans face a stark choice: seek medical attention or preserve their financial security. This dilemma has only intensified in recent years as the cost of care has surged faster than wages and general inflation. According to the latest data, 35% of Americans unable to access care amounts to over 91 million individuals nationwide. These trends threaten not only individual health but the stability of communities and our economy as a whole.
Behind these numbers lie stories of families skipping medications, postponing preventive screenings, and confronting medical debt that can last for years. The burden falls most heavily on vulnerable populations: low-income households, racial and ethnic minorities, and the uninsured. As we navigate policy debates and shifting political winds, it is vital to understand both the human impact and the systemic drivers of rising healthcare costs.
In 2023, total health spending reached $4.9 trillion, marking a 7.5% annual increase that dwarfs overall economic growth. On a per capita basis, Americans now spend approximately $14,570 on healthcare each year, driven by high prices for hospital care, prescription drugs, and specialty treatments.
Medical inflation in mid-2024 stood at 3.3%, compared to a 3.0% rate for general consumer prices. As a result, more than half of U.S. households allocate at least 10% of their budgets to healthcare, with some low-income families spending up to 25%. These figures highlight the unsustainable trajectory of costs that outpace wage growth, forcing many to forgo essential services.
The burden of unaffordability is not evenly distributed. Racial and ethnic minorities report significantly higher difficulty in accessing care. A staggering 52% of Hispanic adults and 46% of Black adults struggle to afford quality healthcare, compared to much lower rates among White adults. Income plays a similarly decisive role: over 64% of individuals earning less than $24,000 annually face barriers to needed services.
Even insured Americans are not immune. Underinsurance leaves many facing steep deductibles and co-payments, leading to financial strain and avoidance of treatment. These disparities underscore the urgent need for targeted policies that address the root causes of inequity.
When cost becomes a barrier, health outcomes suffer. In 2023 alone, 28% of all adults reported delaying or skipping medical care because of expenses. Among New Yorkers, that figure climbs to 66%, illustrating the severe local impact in high-cost regions. Patients ration prescriptions, skip follow-up visits, and delay critical screenings, compounding long-term risks.
Medical debt remains a persistent scourge. Despite debt forgiveness programs and payment assistance, underlying affordability issues persist. Families find themselves choosing between filling prescriptions and covering other essentials like rent and food. These heartbreaking trade-offs highlight the human toll of economic pressures that too often go unseen.
The Affordable Care Act’s marketplace has been a critical lifeline for millions. For 2025, a record-high 24.2 million Americans selected coverage, aided by enhanced federal subsidies that reduced premiums dramatically. Young adults earning $30,000 per year now pay as little as $50 per month, down from $165, and some plans are available for under $10 after tax credits.
However, these subsidies are set to expire after 2025 unless renewed by Congress. The Congressional Budget Office projects that making them permanent would extend coverage to an additional 3.6–3.8 million people over the next decade, with a federal cost of approximately $349.8 billion. Employers also anticipate average healthcare cost increases of 6.7% for 2025, highlighting the shared responsibility across public and private sectors.
Addressing the challenges of cost and access requires a multifaceted approach that balances the needs of patients, providers, and payers. Public sentiment is clear: voters across demographic groups demand accountability and transparency in pricing. To harness this momentum, policymakers and stakeholders can pursue several key reforms:
By forging consensus around these reforms, we can begin to bend the cost curve and ensure no American has to choose between health and financial stability. It will take sustained public pressure, political will, and innovative partnerships to create a system that works for all.
The path forward will not be easy, but the stakes could not be higher. Ensuring equitable access for every community is not just a policy objective—it is a moral imperative. As we look ahead, let us commit to a future where healthcare is a right, not a privilege, and where affordability and access go hand in hand.
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