Percentage of U.S. adults considered "Cost Desperate" according to the Healthcare Affordability Index in 2021 and 2024, by annual household income
(in U.S. dollars)
Annual income in U.S. dollars
2021
2024
<24K
14%
25%
24°â‰¤48°
13%
19%
48°â‰¤90°
11%
12%
90°â‰¤120°
4%
5%
120°â‰¤180°
3%
3%
180K+
2%
1%
All adults
8%
11%
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The source adds the following: West Health and Gallup developed the Healthcare Affordability Index to track healthcare access and affordability in America. Research has found that people can be classified into one of three categories based on the following criteria:
Cost Secure individuals have access to quality, affordable care and can pay for needed care and medicine.
Cost Insecure individuals lack access to quality, affordable care or have recently been unable to pay for either needed care or medicine.
Cost Desperate individuals lack access to quality, affordable care and have recently been unable to pay for needed care and medicine.
Citation formats
Cost desperate adults in the U.S. 2021-2024, by income
According to the Healthcare Affordability Index survey conducted in 2024, around 25 percent of adults in the U.S. with an annual household income of less than 24 thousand U.S. dollars were "cost desperate", meaning they lacked access to quality, affordable care and have recently been unable to pay for needed care and medicine. This figure has nearly doubled since 2021, when only 14 percent were considered "cost desperate". Healthcare affordability gap is widening as the opposite is seen among those most high-earning, where a smaller share were considered "cost desperate" in 2024 compared with 2021.
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Gallup, & West Health. (April 2, 2025). Percentage of U.S. adults considered "Cost Desperate" according to the Healthcare Affordability Index in 2021 and 2024, by annual household income (in U.S. dollars) [Graph]. In ÌÇÐÄÆƽâ°æ. Retrieved August 05, 2026, from /statistics/1341342/healthcare-affordability-index-of-adults-in-the-us/
Gallup, und West Health. "Percentage of U.S. adults considered "Cost Desperate" according to the Healthcare Affordability Index in 2021 and 2024, by annual household income (in U.S. dollars)." Chart. April 2, 2025. ÌÇÐÄÆƽâ°æ. Accessed August 05, 2026. /statistics/1341342/healthcare-affordability-index-of-adults-in-the-us/
Gallup, West Health. (2025). Percentage of U.S. adults considered "Cost Desperate" according to the Healthcare Affordability Index in 2021 and 2024, by annual household income (in U.S. dollars). ÌÇÐÄÆƽâ°æ. ÌÇÐÄÆƽâ°æ Inc.. Accessed: August 05, 2026. /statistics/1341342/healthcare-affordability-index-of-adults-in-the-us/
Gallup, and West Health. "Percentage of U.S. Adults Considered "Cost Desperate" According to The Healthcare Affordability Index in 2021 and 2024, by Annual Household Income (in U.S. Dollars)." ÌÇÐÄÆƽâ°æ, ÌÇÐÄÆƽâ°æ Inc., 2 Apr 2025, /statistics/1341342/healthcare-affordability-index-of-adults-in-the-us/
Gallup & West Health, Percentage of U.S. adults considered "Cost Desperate" according to the Healthcare Affordability Index in 2021 and 2024, by annual household income (in U.S. dollars) ÌÇÐÄÆƽâ°æ, /statistics/1341342/healthcare-affordability-index-of-adults-in-the-us/ (last visited August 05, 2026)
Percentage of U.S. adults considered "Cost Desperate" according to the Healthcare Affordability Index in 2021 and 2024, by annual household income (in U.S. dollars) [Graph], Gallup, & West Health, April 2, 2025. [Online]. Available: /statistics/1341342/healthcare-affordability-index-of-adults-in-the-us/
