You probably already feel it: the grocery bill climbs, the electric bill climbs. Then the explanation-of-benefits letter shows up, and the number at the bottom doesn’t make sense.
But for tens of millions of Americans, the math has gotten so bad that they’re now choosing between eating dinner and filling a prescription. A major new survey just put hard numbers on how deep those tradeoffs run, and the scale of the problem should concern anyone who pays for health care in this country.
82 million Americans cut daily expenses to cover health care bills
Roughly one-third of U.S. adults reported cutting back on food, utilities, or other daily expenses to afford health care in 2025, according to a West Health-Gallup Center on Healthcare in America survey conducted in Mid March 2026. More than 82 million Americans said they made at least one tradeoff in daily spending to pay for medical care.
The survey polled nearly 20,000 adults across all 50 states and the District of Columbia between June and August 2025. The sacrifices people described ranged from skipping meals and cutting utility use to driving less and borrowing money to pay medical bills, CNN reported.
Uninsured Americans face the steepest sacrifices
If you don’t have health insurance, the pain is far worse. Among uninsured respondents, 62% said they made at least one sacrifice to pay for health care, GV Wire reported. That includes 32% who had to borrow money and 24% who stretched out their current medication to make it last longer.
Among uninsured Americans surveyed:
- 62% made at least one daily expense tradeoff to pay for health care
- 32% borrowed money to cover medical costs
- 24% prolonged their current medication rather than refilling on time
But the problem does not stop with the uninsured. Among those with insurance, close to three in 10 reported making at least one sacrifice. Higher premiums and steeper out-of-pocket costs are squeezing even those who technically have coverage.
Most Americans with private health insurance are paying higher premiums and steeper out-of-pocket costs in 2026, including millions on government-subsidized ACA plans where the extra pandemic-era subsidies have now expired.
Even insured Americans are struggling
Ellyn Maese, research director for the West Health-Gallup Center on Healthcare, put it bluntly in an interview with CNN.
The cost pressure is no longer limited to lower-income or uninsured households. It has spread across income levels.
Health care costs are forcing Americans to delay surgeries, homes, and retirement
A second West Health-Gallup survey, conducted between October and December 2025 with 5,660 U.S. adults, found that health care costs have pushed tens of millions of Americans to postpone major life decisions in recent years.
Life events delayed due to health care costs:
- Just over 25% delayed surgical or medical treatment.
- 14% held off buying a new home.
- Nearly 9% postponed retirement.
- Roughly 18% delayed a job change.
If you’ve been putting off a surgery or a needed procedure because you can’t absorb the out-of-pocket bill, you’re far from alone. And these delays carry their own costs. Conditions left untreated generally become more expensive, more complicated, and more dangerous over time.
Postponing retirement or holding off on a job change can also compound financial stress. You may stay in a role that no longer fits because the health benefits feel irreplaceable, or you may push back retirement into a period when your health needs are higher, and your earning power is lower.
U.S. health care spending hit $5.3 trillion in 2024, and it keeps climbing
This survey arrives against a backdrop of record health care spending. U.S. health care expenditures reached $5.3 trillion in 2024, or $15,474 per person, growing 7.2% from the prior year, according to the Centers for Medicare & Medicaid Services. Health spending now accounts for 18% of GDP.
CMS projects health spending will grow an average of 5.8% annually through 2033, outpacing GDP growth of 4.3%, according to a Health Affairs analysis of CMS projections. By 2033, health care’s share of the economy is projected to reach 20.3%.
Americans are getting sicker and spending more
Tim Lash, president of West Health, told CNN that the country’s overall health is declining, with rising rates of metabolic disease, depression, and anxiety driving higher utilization.
Americans are not just paying more for health care; they are in need of more access to it. Per capita health expenditures are projected to grow from $16,570 in 2024 to $24,200 by 2033, according to the Peterson-KFF Health System Tracker analysis of CMS data.
Expired ACA subsidies are pushing millions toward unaffordable premiums
Congress allowed enhanced Affordable Care Act premium subsidies to expire at the end of 2025. Those subsidies had been keeping premiums manageable for an estimated 20 million people.
Without them, ACA marketplace premiums jumped an average of 26% for 2026, according to KFF.
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For subsidized enrollees, the expiration of enhanced tax credits drove out-of-pocket premium payments up by more than 75% on average; and subsequent KFF modeling put the increase even higher, at approximately 114%, or more than double what enrollees had been paying, according to the Peterson-KFF Health System Tracker.
CMS projects that 4.7 million people will lose direct-purchase insurance coverage in 2026 as a result of the subsidy expiration, representing a 12.3% decline in direct-purchase enrollment, according to the agency’s National Health Expenditure Projections.
If you’re on an ACA plan, you may already be feeling this. TheStreet has reported on how households above 150% of the federal poverty level face the steepest hikes. Some families are now choosing between paying their health insurance premiums and putting food on the table.
Medicare costs are climbing for seniors on fixed incomes
If you’re on Medicare, 2026 brought its own round of increases. CMS announced that the standard Part B premium rose to $202.90 per month, up $17.90 from 2025. That’s a 9.6% jump, more than three times the 2.8% Social Security cost-of-living adjustment for 2026.
Key Medicare cost increases for 2026:
- Part B monthly premium: $202.90 (up from $185)
- Part B annual deductible: $283 (up from $257)
- Part A inpatient hospital deductible: $1,736 (up from $1,676)
- Daily coinsurance for days 61-90 of hospitalization: $434 (up from $419)
For retirees on fixed incomes, a bigger share of every Social Security check is going straight to Medicare. And that’s before you account for out-of-pocket spending on prescriptions, specialist visits, or services Medicare does not cover, such as dental, vision, or long-term care.
TheStreet has reported on how this Part B increase is eroding the purchasing power of Social Security checks for millions of retirees.
One retired librarian’s story shows how quickly the math falls apart
Sheila Nesbit, 65, recently retired after a long career as a librarian. She lives in Park Forest, a suburb south of Chicago, and she didn’t realize that Medicare would cover less than her former employer-sponsored insurance plan did, CNN explained.
When her doctor recommended new orthopedic shoe inserts costing roughly $250, she decided not to buy them. She’s hunting for discount cards to afford a $90 medication that Medicare does not cover.
She sometimes skips lunch, and she doesn’t always take her medications for cholesterol, asthma, and high blood pressure. She’s lowered her thermostat and wraps herself in a sweater and two blankets to ward off the cold. Her story is not unusual; it’s the kind of tradeoff that 82 million Americans are now making in some form.
Steps you can take to reduce the damage to your budget
You can’t control what health care costs. But you can take specific steps to limit how much of your household budget it consumes.
Review your coverage every year
Whether you’re on an ACA plan, employer coverage, or Medicare, do not assume last year’s plan is still the best fit. Networks change, formulas change, and premiums shift. Compare options during every open enrollment period.
Use every assistance program available
- If you’re on Medicare, check whether you qualify for the Medicare Savings Program or Extra Help for Part D prescription costs.
- If you’re on an ACA plan, verify your income estimate with your state marketplace. Even a small adjustment can change your subsidy amount.
- Look into drug manufacturer discount programs, GoodRx, or state pharmaceutical assistance programs.
- Ask your doctor about generic alternatives or therapeutic substitutions before accepting a brand-name prescription.
Do not skip medication or delay treatment
Stretching prescriptions or postponing procedures might seem like a way to save money, but it typically leads to higher costs later. Talk to your doctor about lower-cost alternatives or patient assistance programs before cutting corners on your care.
Build a health care line item into your monthly budget
Too many households treat medical bills as surprises. If you’re on Original Medicare, plan for roughly $3,500 to $7,000 per year in out-of-pocket costs, depending on your health needs. If you’re on an ACA plan, know your deductible and out-of-pocket maximum and set money aside each month.
The financial squeeze on American households is tightening
With millions more expected to lose insurance coverage, health spending projected to consume a fifth of the economy within a decade, and household health deteriorating across the board, the pressure on family budgets is only increasing.
Maese, the West Health-Gallup researcher, warned CNN that if more people lose their insurance, the tradeoffs already affecting 82 million Americans will spread even further.
If you’re already stretching your budget to cover medical costs, the most important thing you can do is plan now. Review your coverage and seek out every assistance program you qualify for. Treat health care spending like the fixed cost it has become, not an expense you deal with after the bill arrives.
Related: Paying cash for U.S. medical care could save you a fortune
