Half of adults struggle to afford healthcare, despite insurance coverage

New data shows that nearly half of working-age adults struggled to afford healthcare in 2025, with researchers noting that having health insurance coverage doesn't help defray high medical costs.

The report from researchers at the Urban Institute in partnership with the Robert Wood Johnson Foundation found that healthcare affordability remains an uphill battle for consumers.

These findings come as industry experts keep an eye on the impact of recent federal insurance policies on healthcare coverage and, by extension, affordability.

"These findings highlight widespread difficulty in affording health care across the United States," Michael Karpman, principal research associate at the Urban Institute, said in an emailed press release. "Recent federal policy changes could exacerbate these difficulties by increasing the number of people who are uninsured. And if more employers shift the rising costs of health care to their employees, affordability challenges will increase."

Notably, healthcare affordability problems defied insurance status, the survey of 10,000 U.S. adults ages 18-64 showed.

Uninsured adults are the most likely to have had healthcare affordability issues in 2025, with 60% reporting as much. However, folks with health insurance also felt the pinch, albeit to a lesser extent.

According to the analysis, 39% of folks with an employer-sponsored health insurance had a healthcare affordability challenge in 2025, compared to 54% of those who purchase their own coverage and 57% of those enrolled in Medicaid.

Other characteristics, such as health status and race, also impacted healthcare affordability.

For example, 69% of folks with a disability had trouble affording their healthcare last year. A similar proportion (65%) of those in fair or poor health had an affordability issue, as did folks with chronic conditions.

Specifically, more than 60% of those who've ever been diagnosed with a stroke, chronic obstructive pulmonary disease (COPD), cancer, heart disease or diabetes reported healthcare affordability issues.

There were also racial health disparities at play. Just over half (56%) of Black and Hispanic adults had healthcare affordability issues, as did 54% of adults of additional unlisted races. This compares to 42% of White adults and 28% of Asian adults who faced affordability barriers.

These disparities are notable, considering what's at stake when a patient can't afford their healthcare.

According to the researchers, 35% of families facing a healthcare affordability challenge ultimately had an unmet healthcare need, meaning they didn't access medical care when they needed it. This trend was more pronounced among uninsured individuals, those enrolled in Medicaid and those who purchased their own plan on the individual market.

But high healthcare costs can mean more than just missing care. For example, anywhere from a quarter to a third of families incur medical debt from a high bill after they've accessed care. This was least common among those with employer-sponsored health insurance (26%) and most common among those with individual market coverage.

More generally, families report trouble paying the high medical bills they receive.

This was true for 30% of those with individual market coverage, 25% of those with employer-sponsored health insurance, 24% of those without any insurance and 22% of those with Medicaid coverage.