Quality health care is unaffordable for an estimated 46 million Americans, according to a new study from Gallup and health care research firm West Health.

A web survey of 3,753 adults living in all 50 U.S. states conducted from Feb. 15-21 via the Gallup Panel, a research panel built to be representative of the entire U.S. population, indicated that an estimated 46 million people (or 18% of the U.S. population) would be unable to pay for health care if they needed to access it.

“I wasn’t particularly surprised — one of the big takeaways from this is that over the course of the last year, the pandemic has a way of pushing the urgency of the health care crisis off of front pages, since COVID is obviously a health care issue,” Dan Witters, senior researcher at Gallup, told Yahoo Finance.

Roughly the same number of people surveyed indicated that "someone in their household skipped care they needed for cost reasons in the prior 12 months," according to Gallup. That is especially true for of low-income earners: 35% of low-income were unable to pay for quality health care amid the pandemic.

“People who are low income just don’t have as much available room in their budgets to spend on health insurance,” Cynthia Cox, vice president at the Kaiser Family Foundation, told Yahoo Finance. “More of their budget is taken up by housing and food and other necessities.”

Being unable to afford health care is nothing new to Americans: Yahoo Finance reported in March 2020 that almost a third of families — 32% — decided not to seek medical care in the previous year due to cost.

And over the last decade, Americans increasingly turned to crowdfunding: A Journal of American Medical Association (JAMA) study found that between May 2010 and December 2018, 26.7% of the 1,056,455 fundraisers on the crowdfunding site GoFundMe were for health-related costs. And those health-related campaigns sought a collective total of nearly $10.3 billion and raised about $3.7 billion. (Most Americans have held medical debt, with costs averaging between $5,000 to $9,999.)

Race, ethnicity, income

The Gallup/West Health data shows that there are stark health care disparities among certain groups.

When broken down by race, the situation is even worse for communities of color. Among Black Americans and Hispanic Americans, 29% and 21% said they’d be unable to pay, respectively, versus 16% of white Americans.

“We find race, ethnicity, and income dovetailing together,” Witters said. “Part of it’s also going to be a reflection of uninsured rates, which of course is much higher for Hispanics than any other group, and second-highest would be Black adults.”

Data from the Economic Policy Institute (EPI) shows that people of color make up the majority of essential workers in food and agriculture and in industrial, commercial, residential facilities, and services. At the same time, Black workers have also been disproportionately impacted by pandemic-related job losses.

“When you think about lower-paid workers, we’re not just talking about income disparities and power,” Elise Gould, a senior economist at EPI, previously told Yahoo Finance. “You’re also talking about race."

'Don't have as much available room in their budgets'

Those struggling to afford health care could potentially reap the benefits from the recently passed American Rescue Plan Act (ARPA) stimulus legislation.

According to an analysis from the Kaiser Family Foundation,"the majority of uninsured people (63%) are now eligible for financial assistance through the Marketplaces, Medicaid, or Basic Health Plans. In fact, more than 4 out of 10 uninsured people are eligible for a free or nearly free health plan through one of these programs."

The estimated savings per month, according to Kaiser, will be an estimated $70 per month, “ranging from an average savings of $213 per month for people with incomes between 400% and 600% of poverty to an average savings of $33 per month for people with incomes under 150% of poverty.”

The big question is whether that will have a significant effect on America's health care cost burden.

“The American concern over the cost of care was substantial before the pandemic, during the pandemic, and even now as people are getting shots in arms,” Witters said. “We’re slowly starting to exist the worst of the pandemic, but this issue still persists. As the pandemic gets under control and we slowly exit the pandemic era, the cost of health care in America is once again really going to arise in notable consciousness with the American public.”

Adriana Belmonte is a reporter and editor covering politics and health care policy for Yahoo Finance. You can follow her on Twitter @adrianambells and reach her at adriana@yahoofinance.com.

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