Financial Challenges in Health Care Affordability for Working-Age Adults

The Urban Institute has unveiled its December 2025 Well-Being and Basic Needs Survey (WBNS) findings, emphasizing the financial challenges working-age adults face in affording health care. The report reveals that families, especially those with members experiencing chronic illnesses or disabilities, are particularly burdened by health care costs.

Despite possessing health insurance, many Americans struggle to cover medical expenses, as health care affordability lags behind the growth of medical costs. This financial strain leads to delays in seeking necessary treatment, avoidance of prescriptions, and accumulation of medical debt. The looming cessation of enhanced Marketplace premium tax credits in early 2026, combined with anticipated Medicaid and health insurance Marketplace changes, is expected to increase the number of uninsured individuals, exacerbating these fiscal challenges.

The survey, conducted with data from over 10,000 adults, including roughly 8,000 aged 18 to 64, provides a detailed view of household well-being against the backdrop of an evolving safety net. It highlights the general difficulties families face in affording health care, influenced by insurance coverage, health conditions, and demographic factors. Respondents noted changes in expenses over the previous year, with particular attention to health insurance premiums and out-of-pocket costs.