With an aging population, a pandemic and rising medical spending at play, the future of health care may seem bleak. And many Americans are concerned: According to the latest ValuePenguin survey of nearly 2,000 U.S. consumers, 57% feel uneasy about what the future holds for their health care.
Here’s what else we found.
On this page
- Key findings
- Americans have fears about the future of health care
- Uninsured Americans are slightly less concerned
- Many are already experiencing health care struggles
- Health care fears may affect Americans’ health
- Navigating the health insurance marketplace is often confusing
- Choosing a health insurance plan: What consumers need to know
- Most Americans feel insecure about the future of their health care. Although 90% of respondents have health insurance, 57% feel uneasy about the future of their health care. For those with health care-related fears, it’s less about the quality of care available and more about affordability. 29% are troubled by the cost of health insurance and 24% worry about out-of-pocket expenses.
- Unhealthy, uninsured and unbothered? Those without health insurance are less concerned about their future health care, but insurance costs are top of mind. Although 64% of uninsured respondents describe their current health status as fair or poor, uninsured Americans feel slightly less anxious about their health care futures than their insured counterparts (52% versus 58%). Among the uninsured who are worried, 50% say the financial cost of health insurance is their top concern.
- Current health care struggles may amplify future health care concerns. 25% of Americans say they’ve had difficulty accessing necessary medical care in the past year alone. Additionally, 44% say they or someone they know has experienced significant medical debt. Parents of young kids (54%) and millennials (52%) are among the most likely to have experience with medical debt.
- For many, health care-related anxieties may affect physical and mental health. Among those who worry about health care, 40% say they’ve lost sleep over related concerns. This rate is even higher for parents of children younger than 18 (52%), millennials (51%) and Gen Zers (50%). Health insurance providers aren’t helping ease stress, as 31% of policyholders say the process for submitting claims and receiving reimbursements isn’t straightforward.
- Obtaining health insurance may be difficult for those who need it most. While only 38% of all Americans feel confident in their ability to navigate the health insurance marketplace, that drops to 21% among those without health insurance. Additionally, almost a quarter (23%) of uninsured Americans say they aren’t familiar with the health insurance marketplace, and another 23% say they aren’t confident in navigating it.
Americans have fears about the future of health care
Overall, most of our respondents (90%) have health insurance. To break that down further, a quarter (25%) get their health insurance through an employer. Following that, 24% get insurance through Medicare and 18% through Medicaid.
Despite most respondents being insured, 57% say they’re uneasy about what the future holds for their health care, with concerns ranging from insurance to access to affordability and more. Older Americans in particular are concerned, with Gen Xers ages 43 to 58 the age group most likely to have health care worries. Of this age group, 61% say they’re concerned. That’s followed by:
- 58% of baby boomers ages 59 to 77
- 57% of millennials ages 27 to 42
- 51% of Gen Zers ages 18 to 26
The likelihood of sharing these concerns also varies by insurance type. Those insured through a private plan are the most likely to be concerned, with 62% holding fears for the future. Following that, 60% of Americans with Medicaid have similar worries.
The income group most likely to be concerned is those earning between $75,000 and $99,999 a year, at 61%. That’s followed by those earning less than $35,000 (60%). On the other hand, six-figure earners are the least likely to be concerned, at 51%.
For those with health care-related fears, 40% say future financial aspects are more of a concern, while 24% say the quality of future care is more of a problem. Meanwhile, 36% say they’re worried about both. Breaking that down by concern, 29% are troubled by the cost of health insurance and 24% worry about out-of-pocket expenses — the top two fears.
According to ValuePenguin health insurance expert Divya Sangameshwar, these concerns are warranted.
"Health care is already very expensive in the U.S.," she says. "The U.S. accounts for more than 40% of all global health spending — and those expenses are increasing. Sadly, these costs are shifting back to the consumer through higher premiums, copays and deductibles."
Following costs, Americans are also worried about:
- Having difficulty finding good health care providers (13%)
- Losing health insurance coverage (10%)
- Losing health care fairness, equity and access (6%)
- Encountering health care provider shortages (5%)
- Declining quality of care (5%)
- Qualifying for Medicare and Medicaid (4%)
- Paying medication costs (4%)
Some demographics have more prevalent concerns than others. By gender, men (32%) are more concerned about affording health insurance than women (26%). Among age groups, Gen Zers are particularly concerned about the cost of health insurance (36%), while baby boomers are particularly concerned about out-of-pocket expenses (37%).
By insurance type, those insured through a family member (40%) or an employer (37%) are among the groups most likely to worry about cost.
Uninsured Americans are slightly less concerned
Despite a higher likelihood of reporting being unhealthy, uninsured Americans are less concerned about the future of health care than their insured counterparts. Among uninsured Americans, 64% describe their health as fair or poor. (For comparison, 44% of insured Americans say similarly.)
Who’s in the poorest health? By demographic, 64% of those with Medicaid describe their health as fair or poor — tying with uninsured Americans as the most unhealthy group. Not far behind, 62% of those who make less than $35,000 say similarly. Finally, 53% of Gen Xers describe their health status as fair to poor — the highest by generation.
Although they’re less likely to report being healthy, 52% of uninsured Americans are anxious about the future of their health care — slightly lower than the 58% of insured Americans who say similarly.
Sangameshwar says uninsured Americans should be more concerned about the future of health care, particularly because they already have less access to recommended care, receive poorer-quality care and experience worse health outcomes than insured adults.
"This lack of anxiety likely stems from a lack of awareness around the consequences of being uninsured," she says. "It’s also likely they’re not aware of current health care costs since many uninsured Americans aren’t seeking out the care they need. Sadly, skipping medical care due to affordability concerns can only lead to long-term, more expensive consequences."
While uninsured Americans won’t face any difficulties getting approved for coverage by health insurance companies in the future, Sangameshwar worries their lack of knowledge about health insurance may lead them to pick health plans that may not provide them with the coverage they need.
Among the uninsured who are worried, 50% say the financial cost of health insurance is their top concern — significantly higher than the 27% of insured Americans who share that concern.
Many are already experiencing health care struggles
Bad health care experiences may influence Americans’ generally negative opinions about the future of health care. In the past year alone, 25% of all Americans say they’ve had difficulty accessing necessary medical care. That rate is particularly high among those with children younger than 18 (35%), millennials (32%), Gen Zers (32%) and those insured through a private health plan (32%).
A large reason for this, Sangameshwar says, may be because health care networks are always changing.
"A doctor you may have seen in 2022 may not be accepting your insurance in 2023, even if you’re on the same plan," she says. "The shortage of doctors and health care providers also means many aren’t taking new patients, which may exacerbate problems finding care if your insurer isn’t accepting your regular doctor anymore. Plus, in some cases, there aren’t any specialists near where you live — especially if you live in a rural area."
With affordability top of mind for those most concerned about their health care, it may be unsurprising that 44% of all Americans say they or someone they know has experienced significant medical debt. By demographic, parents of young kids (54%), those insured through a private plan (54%) and millennials (52%) are the groups most likely to have experience with medical debt.
Breaking that down further, 25% say someone they know has experienced medical debt, while 22% say they’ve personally experienced it. Those most likely to have personally shouldered medical debt are:
- Those with children younger than 18 (33%)
- Millennials (29%)
- Those with private health insurance (27%)
- Those making between $75,000 to $99,000 a year (26%)
- Those insured through an employer (25%)
- Those making less than $35,000 a year (24%)
Despite the bad experiences, though, 75% of Americans say they’re happy with their health care. That leaves 15% feeling indifferent and 10% feeling dissatisfied. Those without health insurance (30%) are the most likely to feel unhappy about their care. Some distance behind that, those making less than $35,000 (16%) and Medicaid recipients (15%) are among the most likely to be dissatisfied.
Health care fears may affect Americans’ health
Worrying about health care may be a catch-22. Among those with future health care concerns, 40% say they’ve lost sleep by worrying — possibly posing a risk to their current health.
By demographic, parents of children younger than 18 (52%), millennials (51%) and Gen Zers (50%) are the only groups where at least half of those with concerns have lost sleep. It’s also worth noting that 47% of those with private health insurance and 46% with health insurance through their employer reported losing sleep over health care worries — top among insurance types.
Health insurance providers aren’t helping ease stress, either. In fact, 31% of insured Americans say the process for submitting claims and receiving reimbursements isn’t straightforward. That rate’s particularly high among those insured through a family member (40%), Gen Xers (36%) and those earning between $75,000 and $99,999 (36%).
Navigating the health insurance marketplace is often confusing
It’s not just insured Americans getting headaches — difficulty navigating the health insurance marketplace affects all demographics. In fact, only 38% of all Americans feel confident in their ability to navigate the health insurance marketplace, a percentage that drops to 21% among those without health insurance.
Meanwhile, 15% of Americans say they’re not confident and 10% say they’re unfamiliar with the health insurance marketplace. Those rates are notably higher among the uninsured, with 23% reporting they aren’t familiar with the health insurance marketplace and another 23% reporting they aren’t confident navigating the marketplace.
On the other hand, 49% of privately insured Americans are confident in their ability to navigate their health care options — highest by insurance type. Additionally, men (45%) have a higher rate of confidence than women (31%).
Experience may be the best teacher, as 45% of baby boomers cite confidence in navigating the health insurance marketplace — the highest by age group. That compares with:
- 39% of Gen Xers
- 36% of millennials
- 25% of Gen Zers
Meanwhile, 56% of six-figure earners cite a similar confidence — significantly higher than any other income group.
Choosing a health insurance plan: What consumers need to know
As consumers, the future of health care is largely out of our control, but choosing a plan that’s right for you can help mitigate many common concerns. While Sangameshwar says picking a plan is hard, some simple guidelines can help a little. Particularly, she recommends the following:
- Before you pick a plan, write down your specific medical needs. Do you have a chronic health condition that needs regular treatment? Do you need any prescriptions? Does the insurance plan fully or partially cover your prescriptions? Using this information, you can make a more informed choice.
- Know the right terms. "Many Americans in a prior ValuePenguin survey didn’t understand terms like ‘deductible’ or ‘coinsurance’ very well, and few were good at predicting the health care needs they’ll have," Sangameshwar says. "Picking an ideal health plan requires knowledge of all these terms and how it impacts you: Knowing what you might use, what it might cost you and how those expenses combine with the plan’s monthly premium."
- Understand the differences between your options. "For example, Americans who can take on a bigger slice of financial risk or who are in excellent health may prefer the cost savings associated with a high-deductible plan with lower premiums," she says. "Those battling chronic health conditions may find a lower-deductible plan will offer them more health care cost savings. Just going for the ‘cheapest’ option when it comes to a health insurance plan can cost you thousands of dollars extra each year from unexpected medical expenses — especially if you aren’t looking at the whole picture when choosing a suitable health plan for you and your family."
ValuePenguin commissioned QuestionPro to conduct an online survey of 1,950 U.S. consumers ages 18 to 77 from Aug. 18 to Aug. 22, 2023. The survey was administered using a nonprobability-based sample, and quotas were used to ensure the sample base represented the overall population. Researchers reviewed all responses for quality control.
We defined generations as the following ages in 2023:
- Generation Z: 18 to 26
- Millennial: 27 to 42
- Generation X: 43 to 58
- Baby boomer: 59 to 77