Health Care Costs Worry Americans The Most

Marcos Bello was laid off in 2025, and his employer only provided 10 days of healthcare coverage. Like many other workers facing layoffs, Bello had to decide how—or whether—to get health insurance after his coverage ended.

After performing a cost-benefit analysis, Bello, 33, decided to forgo health insurance, even though he knew there would be risks of not having coverage.

“I was a little more cautious. I wasn’t trying to be out skiing or doing anything dangerous,” Bellow said in an interview with Bankrate. “I was conscious even in the gym.”

Despite the risks, Bello described his decision as liberating. “I really felt empowered just knowing all of a sudden, my monthly and quarterly outlay for my medication and health care just got cheaper immediately.”

Bello has joined other Americans who have either lost their employer-sponsored health insurance or dropped their traditional plans because they could not afford them.

The United States spends more on healthcare than any other large, wealthy country, according to the Peterson-KFF Health System Tracker report. This is possibly one of the reasons the KFF Health Tracking Poll found that paying for health care is a major concern for Americans. Two-thirds (66 percent) of survey participants said they were not as worried about paying for food, utilities, rent, or a mortgage as they were about paying for health insurance, out-of-pocket expenses for doctor visits and prescription medications, as well as other health care costs.

The survey participants’ worries come at a time when health care costs are skyrocketing, and the Affordable Care Act’s (ACA) enhanced tax credits have expired. The tax subsidies helped most people who bought marketplace insurance.

“KFF has long found that health care costs are a top concern for people when it comes to household expenses and economic necessities,” Shannon Schumacher, senior survey analyst at KFF, told CBS News. “We’re now seeing it rise to the top. It’s really become top of mind amid rising costs all around and people trying to figure out how to pay for things.”

Some people are choosing alternative ways to access care, such as going to community clinics, paying providers directly at the time of care, and purchasing lower-cost insurance.

Bello said he discovered that he could receive care from community health centers and direct primary care (DPC) practices. With a cost of $100 a month or less, DPC provides patients with unlimited access to a primary care provider, basic lab work, mental health care, and other services.

However, DPC has limitations, which is why it is usually paired with other coverage. For instance, it does not cover hospital care, specialist care, or emergencies. In addition, Michael Botta, president of Sesame, a health care marketplace, noted that DPC does not have a network.

“Also, if a DPC doctor says, ‘l feel a lump on you,’ that DPC membership isn’t going to pay for a biopsy, an MRI, or a specialist visit,” Botta told Bankrate. “You have to navigate the rest of the health care system on your own.”

Prescription Drugs Add To High Healthcare Costs

Prescription drugs are one of the major contributors to rising healthcare costs. One of the reasons for that is the pricing process drugmakers use to cover costs and earn profits. The process involves:

1. Developing drugs. This includes conducting clinical trials, which are required for regulatory approval. If a trial fails, drugmakers must decide whether to redesign the project, re-evaluate the drug dosage, or discontinue the program.

2. Patent protection. By obtaining a patent, manufacturers have exclusive rights to sell their drugs. However, after a patent expires, a generic version can be produced and sold at a lower price than the original.

3. Negotiating prices. Drug prices are negotiated with pharmacy benefit managers (PBM), who negotiate discounts and rebates on prescription drugs for health insurers and employers that offer employee benefits. PBMs are paid based on the discounts. Manufacturers often increase the list price of their products to offset discounts negotiated by PBMs.

In many countries, government negotiators determine the price of prescription drugs. This has motivated U.S. authorities to use those prices as a benchmark for determining drug costs in the United States. The Trump administration is implementing a “most-favored nation” drug-pricing approach to align U.S. prescription drug prices with the lowest prices paid in other developed countries.

But apparently, many patients in the United States still cannot afford their prescription medications. For instance, in Maryland alone, two million people reported skipping or splitting doses of their medication or not filling a prescription at all because of cost, according to a report from the Health Means Everything Consumer Alliance.

Gambling with Health Insurance

The fears of healthcare reform proponents appear to be coming true: Many people, including those with chronic illnesses, are dropping their healthcare insurance because they can no longer afford it. And, the expiration of the ACA’s subsidies has a lot to do with it.

In 2021, ACA plan enrollment almost doubled, going from about 12 million to over 24 million, due to government subsidies that lowered premiums during the COVID-19 pandemic.

When the ACA subsidies expired on January 1, 2026, ACA enrollment fell by 1.4 million people, according to data released by the Centers for Medicare & Medicaid Services (CMS). For those who did not drop their insurance, their premiums more than doubled. The CMS report also found that premium payments are estimated to have increased 114 percent, on average, for subsidized enrollees who stayed in the same plan.

The majority of participants surveyed by KFF said Congress did the “wrong thing” by allowing the ACA’s subsidies to expire. The Trump administration proposes to give health insurance subsidies directly to eligible Americans. It’s not clear how much people would receive, but the proposed amounts are lower than the previous subsidies.

Healthcare reform proponents say it’s time for solutions now. People are open to comprehensive reform because dissatisfaction with the current healthcare system is so pervasive and deep, according to Ezekiel Emanuel, an oncologist and Vice Provost for Global Initiatives at the University of Pennsylvania.

In an opinion article in The Washington Post, Emanuel proposed five “new ideas” to make healthcare more affordable:

• Reform doctor payment incentives.

• Change insurer behavior by adopting more efficient practices.

• Reform drug prices and payments to PBMs.

• Reduce administrative waste by streamlining electronic records, simplifying billing, and reducing administrative overhead.

Until healthcare reforms are actually implemented or ACA subsidies are restored, families will continue to make hard decisions about healthcare.

When Nicole Wipp, 54, found out that her family’s monthly premium would cost more than her mortgage payment, she and her husband dropped their family plan and bought coverage only for their 15-year-old son.

Before making the tough call, Wipp, a self-employed lawyer in Aiken, South Carolina, crunched the numbers. Wipp told KFF Health News, “We decided that, ultimately, it would be better for us to gamble.”

Source Links:

https://www.bankrate.com/personal-finance/alternatives-to-traditional-health-insurance/
https://www.kff.org/public-opinion/kff-health-tracking-poll-health-care-costs-expiring-aca-tax-credits-and-the-2026-midterms/
https://www.fastcompany.com/91491129/why-us-health-care-is-still-the-most-expensive-in-the-world
https://www.cbsnews.com/news/health-care-costs-top-financial-worry-kff-poll/
https://lowninstitute.org/healthcare-tops-list-of-expenses-americans-are-most-worried-about/
https://www.linkedin.com/news/story/healthcare-costs-worry-americans-more-than-other-expenses-6942204/
https://kffhealthnews.org/news/article/priced-out-health-insurance-costs-kentucky-tennessee-south-carolina/