America's health-care failure: Insured, indebted and priced out of treatment
Nearly three in ten U.S. adults have gone without needed medical care in the past year because they could not afford it. In a country where health insurance is a major household expense, paying for coverage still does not guarantee that people can use it.
KFF's September 2026 review of health-care costs found that 28% of adults skipped or postponed needed care because of cost in the previous 12 months. The Federal Reserve separately reported that 26% of adults skipped some form of medical treatment because of cost in 2025. This is not a collection of isolated tragedies. It is a predictable result of a system that puts a financial checkpoint between sick people and treatment.
An August headline in The Independent made an even more explosive claim: 92% of Americans were not going to the doctor because care was too expensive. The underlying number comes from debt-services company JG Wentworth, whose February survey of 1,507 adults found that 92% of insured respondents reported delaying or avoiding some medical care over cost concerns.
That does not establish that 92% of the entire country is currently avoiding doctors. The company's published survey methodology describes a sharply skewed sample: 68.9% of respondents were aged 29 to 44, and 88.7% reported long-term medical conditions. The company did not establish that its sample represented the national adult population or provide an equivalent 12-month measure. The giant headline is questionable. The national crisis it gestures toward is not.
Insurance without security
KFF found that 62% of uninsured adults younger than 65 had skipped or postponed needed care due to cost. Insurance did not eliminate that barrier: roughly three in ten insured adults aged 18 to 64 said they, too, had gone without needed treatment for financial reasons. The United States has created the absurd condition in which a person can possess an insurance card and still be unable to afford seeing a doctor.
The consequences extend beyond a missed appointment. Fifteen percent of adults reported that their health had worsened after they skipped or postponed care for any reason, including cost. Twenty-two percent said they had problems paying medical bills in the past year. Fourteen percent cut spending on household necessities, including food or clothing, to pay health-care bills.
The cost of the insurance itself helps explain why coverage can provide so little financial peace of mind. KFF's 2025 survey of employer plans found average annual family premiums of $26,993, including employer and employee contributions. Workers paid $6,850 toward those premiums on average. For covered workers with a general annual deductible, the average deductible for individual coverage was $1,886.
Families contribute money from their wages to keep insurance, then face deductibles, copayments and services that their plan will not fully cover. The practical question becomes brutally simple: is finding out what is wrong worth the financial risk?
Archive photograph: Providence Centralia Hospital's emergency entrance, Washington, 2014. M.O. Stevens / Wikimedia Commons, CC BY-SA 3.0. Illustrative image; not connected to the survey.
KFF Health News described one such calculation in March. Rhode Island retiree John Galvin postponed a colonoscopy until he could qualify for Medicare, after confronting the expense of the procedure under his existing insurance. A test that might identify a serious illness became a budget decision. That is what happens when the point of care is also the point of financial danger.
A political failure, not an accident
The American system is organized through fragmented private and public payment arrangements. Employers purchase policies, workers pay their share, insurers enforce coverage and cost-sharing terms, hospitals charge for services, and patients often struggle to know their final bill in advance. Every stage may be perfectly legal, yet the outcome for the public is an obstacle course.
Defenders of the arrangement argue that private insurance offers choice, that innovation is expensive and that reforms to financing can produce trade-offs. But the central fact remains unanswered: why do so many insured people report skipping treatment they need? The success of a health-care system should be measured by the care it actually delivers, not by the number of insurance policies it sells.
Universal public financing, stronger protections against out-of-pocket charges, affordable medicines and investment in community clinics are political choices. They raise serious questions about how services are organized and funded, but none is beyond the capacity of a wealthy industrial country. The obstacle is not a lack of medical knowledge. It is how costs, power and access are distributed.
The 92% claim may be a poor estimate of the country as a whole. Twenty-eight percent of adults missing needed care because they cannot pay is damning enough. A country that collects enormous premiums while families ration tests, prescriptions and doctor visits has failed a basic test of public responsibility.
Editorial note: JG Wentworth conducted its survey in February 2026, published the results in April, and The Independent reported on them in August. This article separates that survey's limitations from KFF's and the Federal Reserve's nationally reported findings. Both photographs are archival and illustrative.
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