Rising healthcare costs are forcing Americans to make impossible choices, selling homes, going into debt, and delaying care to afford medical bills. KFF Health News has documented how these expenses are upending lives across the country, with more than 130 people sharing stories of forgoing insurance, rationing medications, and cutting back on doctor visits as housing and food costs also climb.
Bill McAdams, a 45-year-old travel nurse from Florida, was uninsured last year when he suffered a stroke. He couldn’t afford his agency’s health plan, which would have cost $3,600 a month for him and his wife. The hospital sent him a bill for $93,000.
High Costs Push Families to the Brink
In Milford, Connecticut, Janet Marx, 56, sold her childhood home to afford medical care for her lupus and fibromyalgia. She has Medicare and her husband’s employer insurance but still struggled with out-of-pocket costs. “Things are just getting too expensive to afford the house and health problems,” she said.
In Maryland, Sheila Robinson, 61, has a $10,000 deductible on her Affordable Care Act plan. She puts her $659 monthly premium on a credit card and fears going to the doctor. “Every month, I am in the hole,” she said.
Healthcare costs have grown faster than the economy for decades. In 2024, spending hit its highest growth rate in two decades, reaching nearly $5.3 trillion. By 2032, costs are projected to hit 20% of the nation’s GDP, up from just under 19% today.
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While prescription drug prices dropped this year, many Americans still feel the strain. Polling shows healthcare costs remain a top public concern, with nine in 10 Democrats and three-quarters of Republicans saying the system needs major changes.
Employers and Insurers Pass Costs to Patients
Employers are passing rising healthcare costs to employees, and clinicians are charging patients upfront. The GOP-led Congress let pandemic-era ACA subsidies expire, cutting federal health programs to offset tax cuts. The Trump administration has expanded access to plans with higher deductibles, pushing more costs to patients.
The reason behind high U.S. healthcare costs is straightforward: prices charged by hospitals, doctors, and drugmakers are high. For example, while U.S. doctors perform about a third as many inpatient knee replacements as other wealthy nations, the cost per surgery is higher. Hospitals are merging to charge more, and new technologies come with high price tags.
“It’s really everything all together at once,” said Christopher Whaley, a Brown University health policy researcher.
The American system’s structure also drives up costs. Unlike other countries, the U.S. doesn’t centrally set prices or control for quality. More than half of healthcare payments are based on a fee-for-service model, where hospitals and doctors make more by billing more. The complexity of different billing systems and administrative costs adds hundreds of billions to the price tag.
In Omaha, Nebraska, Carmilla Collins, 52, a single mother, had her wages garnished after she couldn’t pay medical bills from when she was insured and uninsured. She put off thyroid surgery for four months as a goiter swelled against her throat. “I equated taking care of my health with debt that I couldn’t afford,” she said.
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Lynn Ludaway, 40, of Illinois, considered divorcing her husband to qualify for aid after being diagnosed with multiple sclerosis. She raided her savings and retirement accounts, now paying a $500 monthly premium but still ineligible for assistance. “I am in this weird in-between,” she said. “I need to rest to heal, but I need to work to live.”
Even healthcare workers struggle. Shayna Sanders, a marriage and family therapist in Connecticut, pays nearly $1,000 monthly for her own insurance. “Some of the health insurance plans that they have, I probably couldn’t afford them myself due to the cost,” she said.
Reducing healthcare costs faces steep political odds. The health sector has spent more than $14 billion lobbying Congress since 1998. Current proposals focus on shifting costs rather than lowering them. The GOP prioritizes tax cuts, while Democrats have fought to extend ACA subsidies. Progressive Democrats are reviving calls for “Medicare for All,” but such a system wouldn’t necessarily cut overall spending.
Systemic Pressures and Political Gridlock
Damien Waikoloa, 35, in Honolulu, saw his ACA plan premiums rise to over $400 a month. He cut back on business costs, dining out, and travel to afford coverage. “Things like saving for a down payment for a house or even starting a family have completely gone out the window,” he said.
The GOP prioritizes tax and spending cuts, putting more costs on patients and potentially increasing the number of uninsured.
