Worries over healthcare affordability reach new depths among consumers
More than a third of survey respondents report they’re losing sleep over costs, with nearly half delaying treatment over the expense.
“Well, it’s not worth losing sleep over that.” But when it comes to healthcare expenses, that’s exactly what some consumers are experiencing.
A national survey finds an increasing number of Americans are extraordinarily worried about the affordability of healthcare. The new survey, from Imagine360, a Philadelphia-based health plan for self-funded employers, used worry-based impacts on sleeping habits as a way to gauge consumer concern about healthcare costs.
The affordability of healthcare has increasingly gained attention in recent years. Last month, it was the focus of a hearing before the health subcommittee of the House’s Energy and Commerce Committee. Testimony focused on the many challenges facing the industry in restraining cost increases, while improving quality and access.
In conducting its survey, Imagine360 went beyond just asking whether individuals had concerns about costs or couldn’t afford care – it went to the heart of the matter by asking if costs had unnerving effects on their lives.
In answering a qualitative question, more than one in three insured Americans (36 percent) say they’re losing sleep over the cost of care. Those fears among the insured come adjacent in time to reductions in funding for federal healthcare programs and the elimination of enhanced subsidies for those covered by the Affordable Care Act.
Affordability remains a concern for many reasons, especially as a recent U.S. Federal Reserve survey suggests that nearly 40 percent of Americans didn’t have cash on hand to pay an unexpected $400 expense.
The effects of healthcare costs
The survey gathered responses from 2,500 insured adults, with nearly all reporting that they believe that healthcare is too expensive. Respondents weren’t low on the income scale – about 36 percent reported a household income at or below the U.S. median of $83,730, and 80 percent received healthcare coverage through an employer.
Even so, the survey found that nearly half (44 percent) of respondents are skipping or delaying needed treatment, up from 38 percent opting to delay care in 2025. Nearly half (45 percent) of those individuals reported that their medical conditions got worse because they’ve deferred care.
From an employment perspective, some 40 percent of respondents said they would be willing to take a 10 percent reduction in pay if it meant health benefits would be more affordable as a result. And nearly three-quarters of respondents said health plan benefits significantly influence decisions on job choices.
The emotional toll is also worrying, researchers contend, saying the high percentage of those losing sleep over health affordability has dangerous downstream effects on health and availability for high-quality work. “This lack of quality sleep not only diminishes emotional well-being, but exacerbates productivity losses, absenteeism and chronic disease risks. The Integrated Benefits Institute estimates that this costs U.S. employers nearly $3,000 per employee annually,” they wrote.
Impact on employers
Providing healthcare coverage for employees continues to be a heavy burden for their employers, the Imagine360 researchers noted.
The average annual cost of employer-sponsored family health coverage now is nearing $27,000, causing them to conclude that “affordability is becoming an increasing concern for both businesses and working families.”
Imagine360 predicts that employer healthcare costs will rise at nearly double-digit rates in 2026, impacting both businesses’ ability to absorb those costs and likely meaning more expensive health insurance expenses for employees, who typically take on some of the burden for health plan cost increases.
“For the roughly 60 percent of Americans who rely on coverage through their employer, those increases have a direct and meaningful impact on financial well-being,” researchers conclude.
"Healthcare affordability has reached a crisis point," said Jeff Bak, CEO and president of Imagine360. "This isn't just a financial issue; it's a public health emergency when people are losing sleep or skipping care over costs.
“Both families and employers are at a breaking point. The current state of U.S. healthcare costs is not sustainable and demands that we reassess how it's administered, delivered and paid for."
Fred Bazzoli is the Editor in Chief of Health Data Management.