Many Americans — Including Older Adults — Struggle to Afford and Access Healthcare

In the U.S., working adults pay into Medicare, the federal health insurance program for people over 65 and younger individuals with disabilities. While Medicare serves as the primary coverage for most older adults, significant gaps remain, particularly in services like dental, hearing, and vision care, as well as steep cost sharing for services not covered.¹ These gaps leave many older adults facing the very financial burdens Medicare was designed to ease.

Recent surveys conducted by West Health and Gallup highlight these troubling trends. Through the development of the West Health-Gallup Healthcare Affordability & Value Index, researchers have tracked public experiences with the healthcare system and identified those considered “cost secure,” meaning they haven’t recently struggled to afford care and feel confident they could access quality treatment if needed today.

Unfortunately, these insights reveal growing struggles:

· Since 2021, the proportion of adults aged 65 and older classified as “cost secure” dropped from 73% to 71% in 2023.

· One in five older adults report they would be unable to afford quality healthcare if needed today.

· A concerning one-third express worry about their ability to pay for necessary care in the coming year.

These findings challenge the common perception that older adults, because of Medicare, are shielded from affordability and access concerns. Instead, many face difficult trade-offs. Respondents reported cutting back on essentials like utilities and food to pay for healthcare. Even more troubling, a significant number shared that they had lost family members or friends in the past year due to an inability to afford treatment.

As the older adult population grows and healthcare needs become more complex, these insights point to both a challenge and an opportunity. Policymakers must act to close the gaps in Medicare and strengthen access to affordable, high-quality care. By prioritizing older adults, we can alleviate financial strain, prevent difficult sacrifices, and ensure they receive the care they need to age well.

Learn more about the data and explore insights from the West Health-Gallup Healthcare Affordability & Value Index.