HealthEquity finds 36% of Americans delay care due to cost
HealthEquity's Spring 2026 survey reveals 36% of Americans delayed medical care due to cost in the past six months, with financial preparedness falling to 42%. The report highlights significant disparities across demographics, with lower-income households and younger workers most affected. HSA holders show markedly higher financial readiness and benefits literacy compared to non-HSA individuals.
*this image is generated using AI for illustrative purposes only.
Healthcare affordability remains a critical pressure point for American workers, with more than one in three delaying or avoiding care due to cost, according to new research from HealthEquity. The findings, released as part of HealthEquity's second Healthcare Affordability Pulse, show how these pressures are shaping care decisions, workplace productivity, and financial preparedness across American households.
HealthEquity's Spring 2026 survey found that 36% of respondents reported delaying or avoiding needed medical care due to cost in the past six months. Despite a 16-point jump in benefits understanding since the Fall 2025 wave, the share of consumers who feel financially prepared for healthcare expenses fell from 50% to 42%. A recent Gallup poll cites healthcare affordability as Americans' top domestic concern.
Impact on Demographics
Among the 36% of respondents who reported delaying care, the most commonly skipped services were specialist visits, prescription medications, and diagnostic tests. The impact is sharpest among specific demographics:
| Demographic | Percentage Delaying Care |
|---|---|
| Chronic condition patients | 44% |
| Lower-income households (under $50,000) | 46% |
| Gen Z | 45% |
| Millennials | 42% |
| Gen X | 30% |
| Boomers | 29% |
Skipping care merely defers costs and often multiplies them. Commonwealth Fund research shows that more than half of adults with employer coverage who delayed care reported their health problems worsened as a result. Studies have shown that medication non-adherence alone adds more than $5 billion annually to the U.S. healthcare system.
Workforce Productivity
The ripple effects of healthcare affordability pressure extend to the workplace. Nearly half of all respondents (48%) say they are more financially worried now than six months ago. Millennials are four times more likely than Boomers to report being highly distracted at work due to financial strain (32% vs. 8%).
Workers lose an average of 7.3 hours of productivity each week due to financial stress, costing U.S. employers an estimated $183 billion annually. Healthcare affordability fuels a vicious cycle: employees under financial stress are not only distracted but more likely to delay or skip care, leading to worse health outcomes and higher absenteeism.
HSA Holder Advantages
Having a Health Savings Account (HSA) correlates with a fundamentally different relationship with healthcare costs. Across every metric, HSA holders demonstrate meaningfully stronger financial readiness:
| Metric | HSA Holders | Non-HSA Individuals |
|---|---|---|
| Affordability (expenses mostly/completely affordable) | 43% more likely | - |
| Preparedness (cover routine expenses) | 49% | 36% |
| Sense of security (account helps preparedness) | 88% | - |
| Benefits literacy (understand very/extremely well) | 72% | 64% |
| Control (quite a bit of control) | 27% | 9% |
"When 88% of HSA holders say their HSA helps them feel more financially secure, the message is clear: HSAs fundamentally change how people experience healthcare costs," said Scott Cutler, HealthEquity President and CEO. "The challenge now is scale. Employers should think about HSAs the way they think about retirement readiness, not as a benefits line item, but as a core part of workforce financial resilience."
The Spring 2026 edition surveyed 1,031 full-time, part-time, and self-employed Americans who were primary or shared healthcare decision makers enrolled in employer-sponsored health plans between Feb. 11 and Feb. 26, 2026.
How might employers adjust their benefits strategies to mitigate the $183 billion annual productivity loss linked to financial stress?
Will the widening gap in care avoidance between younger and older generations drive policy changes for employer-sponsored plans?
What legislative actions could be taken to address the decline in financial preparedness despite rising benefits literacy?
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