Healthcare Affordability Crisis Deepens: PayZen Report Reveals 78% of Americans Struggling Now, 77% Fear Worse Ahead

New 2025 State of Healthcare Affordability Report reveals growing delays in care and mounting financial strain for U.S. households

SAN FRANCISCO  , Dec. 4, 2025 /PRNewswire/ — Today, PayZen, the leading AI-driven patient affordability platform, released its annual State of Healthcare Affordability: The Patient Perspective report. Based on a nationally representative survey of 1,001 Americans who had a hospital visit or surgery in the last 24 months, the report reveals how rising costs are reshaping care-seeking behavior, household finances, and trust in the healthcare system.

This year’s findings paint a stark picture: 78% of Americans say inflation has made care less affordable, and 77% worry costs will worsen in the year ahead. More patients are delaying or skipping needed care, and families are increasingly forced to choose between medical care and major life decisions.

“The data makes one thing clear: the healthcare affordability crisis demands industry-wide action. Without it, more patients will delay or skip care, worsening health outcomes and eroding trust in the healthcare system,” said Itzik Cohen, CEO and co-founder of PayZen. “At PayZen, we’re proving that smarter, more transparent payment models can rebuild that trust and make care more accessible for everyone.”

Key findings include:

Affordability pressures have intensified.

• 71% of Americans worry about out-of-pocket medical costs, matching concern over groceries (71%) and surpassing utilities (69%) and retirement savings (65%).
• Households can now spend just $82/month on out-of-pocket medical expenses, down from $97/month in 2024.

More patients are delaying or skipping care due to cost.

• 38% of Americans postponed or skipped needed medical care in the past year because of cost, up from 36% in 2024.
• Among this group, 52% delayed or skipped follow-up or specialist appointments, 40% went without prescriptions, and 36% skipped preventive care – leading to a cascading impact on patient outcomes.

Families and children are increasingly affected.

• The share of parents delaying medical care for a child or dependent more than tripled, rising from 11% to 34% in a single year.
• 69% of respondents delayed major life milestones like moving, buying a home, or starting a family because of medical costs.

Even commercially insured patients are struggling with the cost of care. 

• Nearly half of marketplace enrollees (45%) and those with employer-sponsored insurance (44%) delayed or skipped care in the past 12 months.
• While 64% of all patients found their most recent hospital bill stressful, nearly the same share of marketplace (59%) and employer-sponsored (58%) enrollees reported stress, exceeding Medicaid (48%) and Medicare (46%) patients.

Patients crave transparency and support, but few receive it.

• 71% of respondents worry about affording out-of-pocket medical expenses, yet only 24% received a cost estimate before scheduled visits, and even fewer were offered financial assistance (17%) or payment plans (16%).
• 83% say clear, upfront cost estimates influence their loyalty to a provider, and 89% would lose trust in providers who fail to discuss payment plans or financial assistance.

“Healthcare affordability has become one of the defining pressures on American families, shaping when and whether people seek care,” said Tobias Mezger, CRO and co-founder of PayZen. “The reality is sobering, but emerging tools can help. AI and automation are giving providers the tools to move from reactive billing to proactive, personalized support – helping patients understand their costs, access the right financial pathway, and feel confident throughout the payment journey. Technology alone won’t solve the affordability crisis, but it can meaningfully reduce the stress and uncertainty patients feel today.”

To download the full report and learn more about how PayZen is partnering with health systems to address the growing affordability crisis with proactive, patient-centered solutions, please visit: https://payzen.com/patient-perspective-2025

About PayZen
PayZen is the AI healthcare affordability platform making care accessible for patients and sustainable for health systems. With the most comprehensive AI data platform and a patient-first mindset, PayZen delivers custom payment options tailored to the individual, helping patients afford the care they need while improving financial outcomes for providers. Recognized by KLAS Research as the top vendor in the space, PayZen is backed by leading investors and led by experienced technology leaders with a proven track record of helping millions of Americans overcome financial challenges. Learn more at payzen.com.

Media Contact
Walker Sands, on behalf of PayZen
360-535-9160
payzen@walkersands.com

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SOURCE PayZen