Healthcare Costs Dominate American Concerns, ACA Approval Rises

A recent West Health-Gallup survey reveals that healthcare costs have become the most urgent health concern among Americans, with 29% citing it as the nation's top health problem. This marks the highest level since 2004 and surpasses issues like healthcare access and obesity. The survey, conducted in November 2025, indicates rising worries about affordability amid ongoing economic pressures and prior to expected premium increases for Affordable Care Act (ACA) enrollees in 2026. While access concerns remain significant at 17%, they have not reached pre-pandemic highs recorded in 2018. Public dissatisfaction with the cost of healthcare is at a record low, with only 16% expressing satisfaction, down from 19% the previous year and a pandemic-era high of 30%. Notably, satisfaction with personal healthcare costs remains stable at 57%, reflecting a distinction between individual experience and national cost perception. Americans also rate their own health insurance coverage positively, with 65% viewing it as excellent or good, yet national coverage is rated less favorably, with only 24% giving it a positive assessment, the lowest in two decades. The heightened concern over costs and coverage is reflected in a record 23% of respondents who consider the U.S. healthcare system to be "in crisis," while 47% believe it has major problems. These concerns have increased over recent years and show partisan variation, where Democratic respondents report greater dissatisfaction compared to Republicans and independents. The survey also shows strong support for federal government responsibility in ensuring healthcare coverage, with 64% endorsing such a role, the highest level since 2007. However, Americans remain nearly evenly split on the preference for a private insurance system versus a government-run system, with 48% favoring private and 46% supporting government-run healthcare. Partisan divides are evident, with most Democrats favoring government-run care and a majority of Republicans supporting private insurance. The ACA's approval rating has reached a new high, particularly among independents, signaling evolving attitudes toward healthcare policy amid affordability concerns. These findings underscore the complex dynamics facing U.S. healthcare policy, where financial concerns and political perspectives intersect amid ongoing debates about the role of government and private insurance.