Survey Finds Gender Gap in Health Care Affordability Perceptions as Premium Subsidies Expire
Authors
January 2026
Women report significantly higher concern about financial burden from rising health care costs.
As policymakers consider options for 2026 health coverage after enhanced Affordable Care Act (ACA) subsidies expired, new NORC data show how people who buy health care through the ACA exchanges plan to navigate increased premiums. These findings reveal a striking gender gap in how Americans are experiencing the financial impact of rising health care costs, with women bearing a disproportionate burden. This research provides decision-makers with important context on public experiences as coverage policy decisions are made.
Women express greater concern than men about the affordability of health care expenses in 2026.
Using NORC’s AmeriSpeak® Omnibus, we asked U.S. adults how worried they are about being able to afford health care-related expenses for themselves and their families in 2026. Across all included measures, women are more likely than men to report being extremely or very worried about health care-related expenses, including:
- Out-of-pocket costs (37 percent vs. 25 percent)
- Unexpected medical bills (36 percent vs. 27 percent)
- Health insurance premiums (30 percent vs. 21 percent)
- Prescription drugs (27 percent vs. 20 percent)
Women’s heightened concerns span every aspect of health care expenses measured in the survey, suggesting a pervasive financial vulnerability not felt as acutely by men.
Women report greater financial strain associated with health care expenses.
Three-quarters of women (77 percent), compared to 62 percent of men, report that their 2026 health care expenses will place a financial strain on their household. When asked about the likelihood that they will make certain lifestyle changes in 2026 because of this strain, women are significantly more likely than men to report being very or extremely likely to take actions, including:
- Cutting back on leisure or social activities (36 percent vs. 23 percent)
- Reducing their spending on food quality or variety (29 percent vs. 17 percent)
- Delaying home maintenance or repairs (27 percent vs. 19 percent)
- Taking on additional work or working more hours (25 percent vs. 13 percent)
These findings suggest that rising health care costs may force women to make difficult choices that extend far beyond medical care, affecting their careers, families, nutrition, and quality of life, in ways that men feel less likely to experience.
The differences between women and men remain significant even when controlling for age, race, education, income, employment, marital status, and household size.
Implications
Women rely more on health care services, partly due to reproductive health needs and preventive screenings. Given that and their greater role in household health care decision-making, policy changes that increase costs disproportionately affect women’s financial security and health access. Monitoring how these gender-based patterns evolve will be essential for understanding the relationships among policy changes, coverage decisions, health outcomes, and access to care.
Methodology
NORC conducted a poll of American adults between December 18 and December 21, 2025, during an AmeriSpeak monthly Omnibus survey. The study included 1,156 interviews with a nationally representative sample (margin of error +/- 3.9 percentage points) from the AmeriSpeak panel, NORC’s probability-based panel designed to be representative of the U.S. household population. View a comprehensive listing of all study questions and tabulations of top-level results for each question in the topline for this NORC Spotlight on Health.
About the NORC Spotlight on Health
NORC at the University of Chicago’s Spotlight on Health is a series of quick-hitting national surveys and analyses on issues vital to health and well-being, conducted using AmeriSpeak’s probability-based panels.
About NORC at the University of Chicago
NORC at the University of Chicago conducts research and analysis that decision-makers trust. As a nonpartisan research organization and a pioneer in measuring and understanding the world, we have studied almost every aspect of the human experience and every major news event for more than eight decades. Today, we partner with government, corporate, and nonprofit clients around the world to provide the objectivity and expertise necessary to inform the critical decisions facing society.
Contact: For more information, please contact Anna-Leigh Ong at NORC at ong-anna-leigh@norc.org or (917) 242-2172 (cell).
