More than half of insured Americans fear they could not afford a serious illness or accident, and a new study puts numbers to that anxiety. The survey found that 56% of insured adults worried about catastrophic out-of-pocket costs. About one in four also said their plan had not covered care they needed and a similar share reported financial strain from costs they were left responsible for.
The findings come from GoodRx Research, which surveyed 1,887 insured adults through YouGov between May and July 2026. They arrive during a renewal cycle already under pressure - average health benefit costs per employee rose 6.7% in 2026, with the same rate projected for 2027, the highest sustained increase in 15 years, according to Mercer's National Survey of Employer-Sponsored Health Plans. In half of US states, single-coverage deductibles have already reached a level the Commonwealth Fund identifies as a marker of underinsurance.
GoodRx's data show that inadequate coverage and unaffordable cost-sharing produce the same outcome: people go without care. Among respondents who needed care their plan did not cover, prescription medications were the most frequently cited gap at 47%, followed by dental services at 35% and medical procedures at 23%.
Where cost-sharing was the barrier, dental care had the highest avoidance rate among financially strained respondents at 52%. Vision care and doctor visits followed at 37%, prescription medications at 31%, and mental health services at 23%. The gap between what a plan excludes and what an enrolled member can afford reflects two distinct underinsurance mechanisms, both present in the data.
A policy shift added pressure. The Affordable Care Act (ACA) enhanced premium tax credits, which had reduced marketplace premiums for millions of enrollees, expired at the start of 2026. The Congressional Budget Office (CBO) projected that around 4 million people would lose coverage as a result, and those who kept their plans faced higher premiums that left less capacity to absorb cost-sharing when care was needed.
The GoodRx survey carries a specific limitation. Respondents were restricted to adults who had taken a prescription in the prior month and held insurance with drug coverage. That population likely over-represents people actively engaged with the healthcare system. The direction of the findings, however, aligns with published data from the Commonwealth Fund and Mercer on the gap between nominal coverage and practical access.
Dental, vision, and prescription gaps are the three categories where employer plan design has the most direct bearing on the care-avoidance rates GoodRx documented. Dental and vision are stand-alone elections employers can offer, expand, or leave off entirely, and among financially strained respondents, those two categories recorded the highest rates of avoided care. Reducing deductible exposure or adding dental and vision benefits can narrow the access gap without requiring any change to the underlying medical structure.
With 2027 renewals approaching, more than half of insured Americans already doubt their plan would protect them from a catastrophic medical event. That share has grown as premiums have risen and deductibles have widened.
