The number landed in June. According to the West Health-Gallup Healthcare Affordability Index (2026), only 49% of US adults are now classified as “Cost Secure,” meaning they can consistently afford healthcare and prescription medications. That’s a five-year low and a 12-percentage-point drop from the 2022 peak of 61%. In a single year, an estimated 2.8 million Americans fell out of that category.
I run MedEscape. Every week I talk with patients who’ve been priced out of care in their own country. This Gallup data puts a number on what I’ve been seeing for two years: the affordability floor is falling, and the people landing on it aren’t just the uninsured. They’re insured Americans whose plans still leave them exposed to four- and five-figure bills.
The affordability crisis is broader than you think
The Gallup index doesn’t measure only the uninsured. It measures whether people who have coverage can actually use it. In 2025, 41% of US adults were classified as “Cost Insecure,” meaning they recently couldn’t pay for either care or medication, and another 10% were “Cost Desperate,” meaning they couldn’t pay for both.
Young adults are hit hardest. Americans aged 18 to 29 saw cost security drop from 46% to 32% since the index launched in 2021 (West Health-Gallup, 2026). Even adults 65 and older, the group most likely to have financial stability, have seen their cost-secure share slide from 73% to 61% over the same period.
The timing matters. The Gallup data were collected before enhanced ACA premium subsidies expired at the end of 2025. The Urban Institute now projects that 4.8 million Americans became uninsured in 2026 as a direct result, a 21% jump in the national uninsured population. KFF estimates that nearly 5 million fewer people will enroll in ACA marketplace plans this year. The affordability picture described by the Gallup data is already worse than the data capture.
What patients actually do when they can’t afford care
When I ask patients how they found MedEscape, the answer almost always starts with a cost problem. They aren’t browsing “medical tourism” out of curiosity. They have a dental quote, a fertility estimate, or a hair restoration consult they can’t pay. Some are insured. Many have coverage that excludes the procedure entirely or carries a deductible so high the insurance might as well not exist.
The procedures I see most fall into categories US insurance covers poorly or doesn’t cover at all: dental implants, IVF, hair transplants, and aesthetic medicine. These aren’t vanity treatments. Missing teeth affect what you can eat and whether you get hired. Infertility is a medical condition. Hair loss from alopecia or medication side effects isn’t cosmetic for the person living with it.
Patients don’t arrive at the decision to go abroad lightly. But when the US price is $4,500 for a single dental implant and the same implant with the same brand (Straumann, Nobel Biocare) costs $1,300 to $2,000 in Mexico, the math is hard to argue with. You can compare these numbers side by side on our treatment cost comparison table.
What the same procedures cost in Mexico, Costa Rica, and Panama
Here’s what I see across our screened provider network, as of mid-2026.
Dental implants. A single implant (post, abutment, crown) runs $3,000 to $6,500 in the US (Dental Roundup, 2026). An All-on-4 full-arch restoration costs $18,000 to $35,000 per arch. In Mexico, a single implant with a premium brand costs $1,300 to $2,000 (Bookimed, 2026), and an All-on-4 runs $7,000 to $13,000. Savings typically land between 50% and 70%, even after flights, hotels, and meals.
IVF. A single cycle in the US averages $20,000 to $30,000 all-in with medications and add-ons (Coastal Fertility, 2026). In Panama, full IVF cycles including ICSI start at $6,500 to $10,000 (Panama Fertility, 2026). In Mexico and Costa Rica, the range is similar. For a couple needing two cycles, the difference can be $20,000 or more. We break down fertility care abroad in detail on our site.
Hair restoration. FUE hair transplants in the US run $6,000 to $15,000 (Cherry Technologies, 2026). In Mexico, the same FUE procedure costs $3,000 to $4,500 (Bookimed, 2026). Packages in Mexico typically include the procedure, local anesthesia, blood work, post-op medications, and airport transfers. Learn more about hair restoration abroad.
Aesthetic medicine. Facelifts, rhinoplasty, body contouring, and other procedures follow the same pattern: US prices are two to four times what board-certified surgeons in Costa Rica and Mexico charge for the same work.
Run your own numbers with our savings calculator.
Why the affordability crisis accelerates cross-border care
This isn’t a new trend, but the Gallup data suggest it’s accelerating. When 51% of Americans are cost insecure or cost desperate, the pool of people weighing care abroad grows. And the ACA subsidy expiration adds fuel. CBS News reported that ACA premiums are expected to rise 26% on average in 2026. Rate filings in some states show median increases of 18%, the highest since 2018.
For self-funded employers watching these numbers, cross-border care is starting to look less like a fringe benefit and more like a cost-containment strategy. I wrote about that angle in a previous post on employer health benefit costs.
How MedEscape works (and what makes it different)
I started MedEscape because I watched people make the right financial decision and the wrong clinical one. They found a cheap clinic on Instagram, sent money, flew down, and had no one reviewing their medical records before treatment. No one coordinating imaging between their US dentist and their provider abroad. No aftercare plan.
MedEscape connects patients with board-certified providers in Mexico, Costa Rica, and Panama. Every provider in our network is pre-screened against licensing, credentials, facility standards, and clinical outcomes. We handle clinical record review, imaging coordination, travel logistics, and aftercare follow-up. You can read exactly how we screen providers.
The Gallup number is going to keep coming up in headlines for the rest of 2026. Whether you’re a patient staring at a quote you can’t pay, an employer looking for a lever nobody mentioned, or a benefits broker searching for a real answer to give your clients, the question is the same: what are you going to do with the number?
I’d start here: gomedescape.com/select-your-category/