For far too many Americans, regardless of insurance coverage, increased healthcare-related out-of-pocket (OOP) costs are creating barriers to the care they need and deserve.

While it’s important to note that some progress was made in 2025 for people enrolled in Medicare through the Medicare Part D cap,¹ premiums and other healthcare costs continue to increase. And individuals with commercial insurance are also facing higher costs, as deductible and OOP spending are becoming unaffordable for many.

A recent national poll conducted by the PAN Foundation’s Center for Patient Research found that with these rising healthcare costs and OOP spending, most insured adults (86%) want policymakers and elected officials to keep affordability top-of-mind when considering healthcare issues in 2026. The top affordability factors of concern are prescription medication costs (33%) and health insurance premium costs (32%).

In addition, many adults (67%) also think policymakers should keep access- and coverage-related factors in mind, namely protecting access through Medicaid (22%). In fact, more than half of adults (57%) are concerned that the "One Big Beautiful Bill" passed this year may prevent access to care for millions of Americans through Medicaid.

Other key findings from our national poll point to a rice in OOP healthcare costs, including:

• Four in 10 adults (40%) will spend more than $1,000 on healthcare-related OOP expenses by the end of 2025. Of those, 9% will spend more than $5,000, including adults with rare diseases (16%), who are most likely to face these higher costs.
• Nearly four in 10 (39%) reported experiencing increased healthcare-related OOP spending between 2024 and 2025.
• More than half of adults (51%) have taken an action this year to afford their healthcare costs, most commonly using their credit card (19%). About 1 in 10 are taking other steps, such as stretching out their prescriptions to make them last longer (11%), delaying/cancelling treatments to afford care (11%), and not filing prescriptions (10%).

Rising premiums are also a concern.

• Over one-third of adults (34%) will have spent more than $1,000 on monthly insurance premiums by the end of 2025, with 18% having spent more than $2,500.
• Nearly half of adults (46%) experienced an increase in healthcare/prescription premiums between 2024 and 2025.
• Health insurance premiums (31%) were the OOP costs that most negatively impacted personal budgets in 2025.
• Nearly half of adults (49%) are concerned about the expiration of the premium tax credits for people via the Affordable Care Act (ACA) marketplace, which are set to expire Dec. 31, 2025, without Congressional action.

What we need from policymakers

So, as we begin a new year, we hope that policymakers and elected officials will ensure access to healthcare for all Americans by continuing to explore strategies to lower what Americans pay for prescription medications at the pharmacy counter while working toward a healthcare system that addresses the total cost of care and ensures healthcare is affordable and accessible to everyone—regardless of where they live, their income, or their background.

About the Author

Amy Niles is chief mission officer at PAN Foundation.

References

1. What Is the Medicare Part D Cap? PAN Foundation. https://www.panfoundation.org/understanding-the-medicare-part-d-cap/

2. Facing Rising Costs, Insured Americans Want Healthcare Access Protected in 2026. PAN Foundation. October 30, 2025. https://www.panfoundation.org/facing-rising-costs-insured-americans-want-healthcare-access/