WASHINGTON (AP) — A growing number of Americans are finding that the responsible financial choice of enrolling in a health insurance plan is not protecting them from medical debt, according to new polling data that shows only about half of U.S. adults could afford health care and had access to quality care last year.
The West Health-Gallup Affordability Index, released June 18, found that concerns about affording health care in the year ahead reached a record high since the polling series began in 2021, signaling deepening anxiety as the nation enters the second half of 2026. The findings come after the expiration of enhanced subsidies under the Affordable Care Act at the end of 2025 — a change that left millions of Americans facing sharply higher premiums.
MSI previously reported that ACA enrollment was projected to drop sharply as costs rose following the subsidy expiration. That analysis highlighted the same financial strain the new poll now documents at the household level.
For Twannetta Weaver, a 43-year-old adult learner in Sanford, Florida, the burden arrived as a slipped disk in her back in 2025. Weaver said she felt she had made the responsible choice when she enrolled in a high-deductible health insurance plan through her employer — a plan that kept premiums low and allowed her to save for retirement. But the medical bills for medication and physical therapy quickly became overwhelming.
“I had to start calculating, am I going to be able to afford to pay my tuition, as well as my books, as well as my living expenses, and continue to care for my family,” Weaver said in an interview. “It makes you feel powerless as a consumer.”
The financial pressure forced Weaver, who was working toward a leadership degree, to delay her graduation by a year — a choice she had not anticipated when she selected her insurance plan based on its low monthly cost.
The polling data points to a broad crisis of affordability. The measure of Americans who said they could access and afford quality care has hovered at about half the population since tracking began five years ago, but the record anxiety about the year ahead suggests the situation is worsening rather than stabilizing. Financial shocks from even routine medical events, like the back injury Weaver sustained, are derailing long-term plans for education, savings, and household stability.
The findings add to a body of evidence that health care costs have become a primary driver of economic insecurity for American households. The expiration of enhanced ACA subsidies — which had lowered premium costs for millions of enrollees — removed a key buffer, particularly for lower- and middle-income families who buy insurance through the marketplace rather than receiving it through employment.