Nearly one-in-five U.S. adults -- 18%, about 46 million people -- report that if they needed access to quality healthcare today, they would be unable to pay for it

This current measure of healthcare unaffordability runs considerably higher among Black adults (29%) and somewhat higher for Hispanic adults (21%) than for White adults (16%). And while unaffordability of care is lower for people 65 and older than for their younger counterparts, White older adults are half as likely to report such a condition as are non-White older people (8% and 16%, respectively).

This survey was conducted by web from Feb. 15-21, 2021, with 3,753 adults, ages 18+, living in all 50 U.S. states and the District of Columbia via the Gallup Panel, a probability-based panel of about 120,000 adults nationwide.

Needed Care Was Skipped by 18% of Households in Prior 12 Months
While 18% of survey respondents reported that that they would be unable to pay for quality care if they needed it today, the same percentage also reported that someone in their household skipped care they needed for cost reasons in the prior 12 months. That time period covers roughly the first year of the COVID-19 pandemic.

The chances of any given household suffering from this form of healthcare insecurity are inversely related to annual household income, with 35% of respondents from low-income households -- those earning under $24,000 per year -- reporting forgoing care in the prior 12 months. That is five times the rate reported by those from high-income households (7%), defined as earning at least $180,000.

Reduction in Household Spending Due to Cost of Care Spans All Income Groups
With nearly one in five U.S. adults forgoing some healthcare in the prior 12 months due to the cost, many Americans are cutting back on household spending to pay for the care that they currently are receiving. About one in eight adults, for example, say they cut back their spending on food (12%) and over-the-counter drugs (11%) to pay for healthcare or medicine. The proportion doing this rises to about 1/4 of those in households earning less than $24,000 annually. Additionally, 21% of those from low-income households have had to reduce spending on utilities due to the cost of care, underscoring the disproportionate sacrifices made by lower-income households in the COVID-era.

Over one-third (35%) of respondents, in turn, report that they have reduced spending on recreational or leisure activities in the previous 12 months in order to afford care, including 21% of those in households earning at least $180,000 per year.

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