Forty-nine percent of Americans say they limit spending on food, housing and utilities to afford healthcare, according to Imagine360’s “2026 Healthcare Cost Report,” published April 13.
Pollfish ran this year’s iteration, surveying 2,500 U.S. adults ages 18-64 with health insurance coverage. Eighty percent get coverage through an employer or spouse.
Imagine360 CEO Jeff Bak spoke with Becker’s about how Imagine360 is interpreting the results — and what employers and health plans should be thinking about.
“It’s coverage, which is better than nothing, for sure,” Mr. Bak said about how the survey respondents all have some form of coverage amid cost-shifting and pricing pressure. “But what you start to do is you start to ration … which means you don’t utilize, which is not good for anybody.”
He said there is “a lot of freight,” such as steep deductibles, that could hold members back from using services and taking advantage of their coverage.
With a 6.7% employee health benefit price increase projected for 2026, employers are starting to look elsewhere, such as self-funded plans, to save. Mr. Bak had some advice for alternative health plans looking to build relationships with employers.
“Make sure you have a hard ROI, and if you can put a guarantee around it or rep and warrant it, all the better,” he said.
Here are five other findings from the report:
1. The vast majority of Americans, 89%, believe healthcare is too expensive.
2. Care costs are more of a concern than quality or access, with 55% of respondents saying that is their biggest worry. More than one-third of respondents said healthcare affordability has kept them up at night within the past year.
3. Forty-four percent of respondents postponed or skipped needed care or medications, up 6% since 2025. Forty-five percent of that group reported that their health condition got worse.
4. Sixty-nine percent said they would travel farther for less expensive care, and 68% would consider looking beyond their employer’s coverage options if that meant reduced costs.
5. Forty-two percent of people said they spend up to 25% of their monthly budget on healthcare, and 41% would go into debt to cover an unanticipated $1,000 medical bill.
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