Survey: Premiums and Out-of-Pocket Costs Top Americans' Healthcare Worries
A new Commonwealth Fund survey reveals that high insurance premiums and out-of-pocket costs are the dominant healthcare concerns for Americans across party lines and coverage types. While most favor federal government action, Republicans lean toward insurers as the solution.
Dive Brief:
- Nearly 4 in 5 U.S. adults identified either high insurance premiums or out-of-pocket spending as the most important problem in the healthcare system, according to a Commonwealth Fund survey released Thursday.
- Affordability concerns cut across party and coverage lines. Premiums were the top problem for 45% of Republicans, 44% of Democrats, and 42% of independents. More than 8 in 10 adults with employer, individual, or marketplace coverage—as well as uninsured adults—said either premiums or out-of-pocket costs were the biggest issue.
- However, Americans are divided over who is best positioned to address the problem. Most respondents said the federal government is best suited to tackle high healthcare prices, while Republicans were more likely to name insurance companies as the appropriate actor.
Dive Insight:
The survey, which polled 25,873 adults from May 4 through May 26, indicates that Americans broadly agree high healthcare costs constitute a bipartisan problem. Premiums ranked as the leading concern among adults, followed by worries over deductibles, copayments, and other costs incurred when receiving care or filling prescriptions.
Respondents diverged along party lines over who should resolve high health costs, such as premiums. Sixty-five percent of Democrats, 49% of independents, and 36% of Republicans said the federal government was best suited to solve the issue of high premiums, while 40% of Republicans chose insurers compared with 19% of Democrats.
The distinction matters: The survey asked respondents which institution was best able to solve the problem, not which specific policy they supported. Consequently, the results do not establish bipartisan backing for subsidies, price regulation, changes to benefit design, or any other remedy.
The survey findings come amid a sharp rise in what consumers pay for coverage. After enhanced federal subsidies expired last year, average out-of-pocket premiums for ACA marketplace plans rose 58% in 2026.
Separately, 48% of large employers told Mercer they expect to make plan changes that increase workers' out-of-pocket spending next year.