Working families are paying much more for health insurance this year, with many postponing doctor’s visits, treatments or filling prescriptions. The number of uninsured Americans is rising as more people wrestle with unpaid medical bills.
This is the stark picture emerging from two surveys released Thursday that show how millions of people in the United States are struggling to keep up with sharply climbing medical costs in recent years.
As the midterm elections approach, Americans are ranking health care near or at the top of their financial concerns, according to a recent poll from KFF, a nonprofit health research group.
Roughly six in 10 adults reported they were very or somewhat worried about affording care.
The majority of Americans — about 157 million — get insurance through their employer. But as costs for coverage have spiked, with increases in the high single digits, businesses have been shifting much more of the additional expenses onto their workforces.
Employees are paying more for coverage, especially if they work for a small business, according to KFF, which released its an annual survey of employers about their health benefits.
Many people are also paying thousands of dollars in medical expenses when they get sick, because companies have increased the plans’ deductibles to offset increases in premiums.
The yearly price, on average, for employees to cover their family is now $7,471 a year, up 9 percent from 2025. The total cost for a family plan, including the amount the employer contributes to the annual premiums, has reached $28,303.
Overall, the average deductible for U.S. workers is approaching $2,000 before insurance kicks in, according to the survey.
“People tell us in polls that their health care costs are their top cost-of-living concern, tied with gas prices. The fact that workers’ share of premiums went up almost three times faster than inflation in 2026 helps explain why,” said Drew Altman, the president and chief executive of KFF, in an email.
Harder hit are employees of small companies, defined as those with fewer than 200 workers, whose paychecks have been shrinking as premiums increase, according to the KFF survey. On average, they are paying $9,687 a year for coverage.
More than a third of people working at a small employer have annual deductibles of $3,000 or more.
Companies are also erecting new hurdles for workers to get care, like cumbersome approval processes for expensive drugs or treatments, the KFF survey found. Another way that businesses are trying to lower costs has been to restrict employees’ choices of doctors or hospitals.
“Employers are paying the equivalent of buying an economy car for each employee who has family health insurance coverage, and in 2026 they offloaded more of that cost to workers,” Mr. Altman said. KFF surveyed more than 1,900 employers with at least 10 workers.
For their part, employers attribute higher costs to several factors, including hospital care, expensive new cancer therapies and expanding coverage of GLP-1 medications for obesity and diabetes.
The rollbacks in government programs like Medicaid and the Affordable Care Act have also left more people without health coverage, according to a separate survey from the Commonwealth Fund, a nonprofit research foundation that analyzes Americans’ experience with insurance every other year. The fund has been a longtime supporter of the A.C.A. and other efforts to expand coverage.
The share of working-age adults who are uninsured rose to 11.2 percent in 2026 from 8.9 percent in 2024, the Commonwealth study showed. Conducted from early May through mid-July, the study has provided one of the first indications of whether people no longer enrolled in Medicaid and Obamacare found other sources of insurance.
The increase in the uninsured rate over the last two years “was really notable,” said Sara R. Collins, a senior scholar at the fund who led the Commonwealth research.
After Obamacare was enacted in 2010, the number of working-age adults and children without insurance fell from around 46 million to a low of about 25 million three years ago. The government changes and soaring medical costs across the broader health sector have fueled a backslide in coverage, bringing the estimated number this year to 30 million uninsured, according to the Congressional Budget Office.
The Trump administration is expected to release official figures on the number of uninsured Americans next year.
The recent increase is statistically significant, Ms. Collins said, and the previous Commonwealth estimates of the uninsured rate have been lower than the official government figures and generally tracked in the same direction.
The Commonwealth survey also noted that about 12 percent of working-age adults reported a gap or lapse in their insurance, the same share as in 2022.
The increase in the uninsured rate was not unexpected, with some estimates showing that nearly five million people dropped their individual coverage. Many were no longer able to afford their Obamacare insurance after President Trump and Republican lawmakers declined to extend pandemic-era subsidies that had helped defray the cost of a typical plan.
Enrollment in Medicaid, the federal-state program for the poor, has also been declining, although the bulk of the cuts to that program as part of Mr. Trump’s One Big Beautiful Bill Act do not take place until next year. Over the last four years, the share of working-age adults enrolled in Medicaid dropped from 15.5 percent to 13 percent, according to Commonwealth.
But the Commonwealth survey, which was based on telephone and online interviews among a sample of 9,360 adults, also underscored how financially insecure people have become about their ability to pay for medical care. The number of people who said they had delayed or skipped care altogether because of the expense increased to 50 percent this year from 46 percent in 2022, according to the survey.
“These reports show the reason why health care costs are at the top of voter concern and outrage,” said Anthony Wright, the executive director of Families USA, a left-leaning consumer advocacy group.
The deepening strains on household budgets are also evident as the rate of medical debt or unpaid bills keeps rising, affecting even those who are insured. About a third of adults with individual policies and those with coverage from an employer reported they were paying off medical bills or medical debt they had already incurred, according to the Commonwealth Fund.
People without insurance tend to have lower levels of medical debt, Ms. Collins of Commonwealth said. “You just use less care if you don’t have insurance coverage.”
The survey found that most Americans believed the federal government had a responsibility to ensure that people had coverage, although Democrats and independents expressed that belief more strongly than Republicans.
“They are mad at hospitals and drug companies and insurers for charging so much,” said Mr. Wright of Families USA. “They are furious at Congress for not reining them in.”
Employers and insurers “have never addressed, not in a significant way, the drivers of health care costs,” Ms. Collins said. “Health care costs are the thing that drives premiums and deductibles.”
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