Americans across party lines and insurance types identify affordability as the most important problem in the U.S. healthcare system, according to a Commonwealth Fund survey published yesterday.
Forty-two percent of respondents named high insurance premiums the top problem, while 36% pointed to out-of-pocket costs such as deductibles and copayments. Together, roughly three-quarters of U.S. adults identified one of the two cost measures as the system’s most pressing issue.
Concern about premiums spanned the political spectrum. Forty-five percent of Republicans, 44% of Democrats and 42% of Independents named premiums their top concern, with out-of-pocket costs close behind. More than eight in 10 people with employer, individual or marketplace coverage, along with those without insurance, cited premiums or out-of-pocket spending as the leading problem.
Respondents diverged on who is best positioned to address the costs. Among those who named premiums the biggest problem, 51% said the federal government is best able to act, including 65% of Democrats, 49% of Independents and 36% of Republicans. Republicans were more likely to point to insurance companies, at 40%, compared with 28% of Independents and 19% of Democrats.
On out-of-pocket costs, 48% of Republicans named insurance companies as best able to address the problem, versus 35% of Independents and 30% of Democrats.
“Across the political spectrum, Americans are telling us the same thing: they’re struggling to afford both their health insurance and the care it is supposed to cover,” said Sara Collins, senior scholar at the Commonwealth Fund, in a news release.
The Commonwealth Fund noted that medical cost trends projected for 2027 are the highest in nearly two decades and that insurers are requesting double-digit premium increases in the Affordable Care Act marketplace. A separate figure cited alongside the survey put the median proposed 2027 rate increase for small group plans at 14%.
