Nearly 20% of Americans, or more than 46 million adults, say they did not seek treatment for a health problem in the last year due to cost, and an equal number say that if they needed some form of healthcare today they would not be able to afford it, according to a new West Health-Gallup survey. The findings come as Americans struggle through a year-plus long pandemic that has claimed over 550,000 lives and put millions of people out of work.

Americans who found themselves unemployed were about twice as likely (38%) to avoid medical care due to cost in the last year. And, while Black, Hispanic and White Americans skipped treatments in roughly equal numbers last year, more people of color are worried about what the future may hold. Nearly one-third (29%) of Black adults—nearly double the number of White adults—and more than one-fifth of Hispanic adults (21%), say if they needed healthcare today, they could not afford it.

“The COVID-19 pandemic has upended life over the last year, and as we begin to emerge from the worst public health crisis in 100 years, we are left with another crisis that has never gone away—the high cost of healthcare,” said Tim Lash, chief strategy officer for West Health, a family of nonprofit and nonpartisan organizations dedicated to lowering healthcare costs to enable successful aging. “Millions of Americans simply can’t afford healthcare and policymakers simply can’t continue to ignore this painful truth.”

In the last year, tens of millions of Americans say they were forced to cut back on basic necessities like food (12%) and utilities (9%) to pay for healthcare, while 35% say they reduced spending on recreational activities and 26% reduced spending on clothing. Nearly 30% found paying for general healthcare a significant financial burden behind housing (51%), taxes (48%) and food (41%). Costs for prescription drugs are a significant financial burden for more than 1 in 5 adults (22%). The survey also found that more than half (52%) of all Americans say they are either “worried” or “very worried” that a health event will wipe out their savings.

This may explain why the American public overwhelmingly favors reforms including setting caps in Medicare on out-of-pocket costs for prescription drugs (88%) and general healthcare services (85%). Majorities of Americans also support lowering the age of Medicare eligibility to 60 (65%), making Medicare available to everyone (60%) and strengthening the Affordable Care Act (59%), though Democrats are much more likely to support these latter three measures than are Republicans. Slight majorities of Independents support the measures.

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