The American Heart Association released a Presidential Advisory on April 30, 2026, warning that health care affordability in the United States has reached a crisis level. Total health care spending is approaching $5 trillion annually and is projected to consume 20% of the nation's gross domestic product within the next decade, according to the advisory. The Association projects that health care costs related to cardiovascular disease will quadruple by 2050.
Rising costs are forcing many Americans to delay or avoid care, contributing to worsening health outcomes and increasing medical debt. A survey from Gallup indicated widespread worry about accessing and affording health care. According to a survey from political pollster McLaughlin & Associates, more than half (51%) of voters say health insurance is their top health concern, followed by hospital bills (11%) and the cost of medicines (10%).
The advisory identifies key drivers of rising costs, including high prices for treatments, administrative complexity, underinvestment in prevention, demographic shifts, and cost shifting to patients. It emphasizes that affordability cannot be addressed through cuts alone; strategic investments in the health care workforce, infrastructure, primary care, data, and public health are also necessary.
The Heart Association outlines five core principles to guide policymakers: access to high-quality care without financial hardship; minimal or no cost-sharing for high-value preventive services; shared accountability across the health care ecosystem for efficiency and transparency; strategic investments in workforce, infrastructure, and data; and strengthening public health infrastructure to address health inequities.
“Health care affordability is one of the defining challenges of our time,” said Dhruv S. Kazi, M.D., M.S., writing committee chair and director of the Cardiac Critical Care Unit at Beth Israel Deaconess Medical Center. “This advisory outlines core guiding principles for action to ensure everyone in this country has access to the care they need and the health care system is sustainable for generations to come.”
Medical debt, a uniquely American problem among high-income countries, is a leading cause of personal bankruptcy. The advisory warns that rising costs impact patients, families, employers, clinicians, and communities nationwide. The Association received funding primarily from individuals, with revenues from pharmaceutical and biotech companies, device manufacturers, and health insurance providers available here.
“We at the American Heart Association believe everyone deserves access to quality health care without financial hardship,” said Nancy Brown, CEO of the American Heart Association. “Affordability is not just an economic issue – it is a health issue that directly affects lives.” More than 8 in 10 U.S. adults say they are confident in the Association to provide trustworthy public health information, according to a recent Annenberg Policy Center poll.
