Growing Healthcare Costs and Their Impact on Insurance Access

A recent survey by the Commonwealth Fund reveals that half of U.S. adults aged 19 to 64 abstained from accessing essential health care due to cost worries in 2026.

This represents a worrying increase from 46% in 2022, underscoring the growing financial strain on Americans seeking medical care. Conducted by SSRS, the 2026 Biennial Health Insurance Survey highlights how both insured and uninsured individuals skipped critical services such as filling prescriptions, undergoing recommended tests, and consulting with doctors, even when ill.

Financial Struggles and Insurance Gaps

The survey found that 30% of working-age adults currently manage medical bills or debt over time, a burden that weighs heavily as the 2027 Affordable Care Act (ACA) open enrollment approaches. Many families may opt for more affordable plans with higher deductibles, but the survey highlights that current insurance coverage often fails to protect consumers from substantial costs. Nearly 46% of working-age adults were inadequately insured, either experiencing gaps or high out-of-pocket expenses despite maintaining insurance throughout the year.

Marketplace Plan Challenges

Individuals enrolled in marketplace plans struggle significantly with costs, with over half of participants going without necessary services and one-third managing medical bill payments. Employer-sponsored plans offered a slight improvement, yet 43% still avoided care due to cost, and 31% found themselves repaying medical expenses. The uninsured rate among working-age adults rose to 11.2% in 2026 from 8.9% in 2024, with those aged 19 to 34 and low-income households experiencing the sharpest increases.

Regulatory Changes and Implications

The survey attributes these trends to the expiration of enhanced marketplace premium tax credits in 2025 and the end of pandemic-era Medicaid enrollment protections. Significant Medicaid changes are expected in 2027, including potential work requirements for most adults, affecting insurance accessibility. This comes as premiums for ACA plans are projected to increase by about 15%, while employer health costs may rise by 9.5% next year. Understanding these dynamics is crucial for insurance professionals advising clients during open enrollment periods.

Key Steps for Cost Management

• Assess financial assistance policies from nonprofit hospitals to reduce charges.
• Consider inquiries about itemized billing and interest-free payment plans.
• During open enrollment, conduct a thorough cost analysis, prioritizing annual expenses.

These steps can help manage the financial burden associated with healthcare. Emergency care scenarios, such as strokes, remain federally mandated to provide necessary screening and stabilization regardless of a patient's financial status, offering some reassurance amidst rising costs.