Americans’ faith in the nation’s health care system has reached a new low, with a combined 70% of adults now describing the system as either in a “state of crisis” or plagued by “major problems,” according to a series of recent Gallup polls. The findings, released December 15, 2025, arrive at a critical juncture as Congress remains locked in a bitter stalemate over the future of the Affordable Care Act (ACA) subsidies—support that millions of Americans rely on to keep their health insurance affordable.
The Gallup survey, conducted in partnership with the West Health-Gallup Center on Healthcare in America, paints a stark picture: 23% of respondents say the U.S. health care system is in crisis, the highest ever recorded by Gallup, while 47% believe it faces major problems. Only a sliver—3%—believe the system is free of problems. The poll, which surveyed approximately 1,300 adults between November 3 and 25, 2025, carries a margin of error of plus or minus three percent.
But what’s fueling this wave of pessimism? Cost, cost, and more cost. Nearly one in three Americans—29%—now cite the cost of health care as the most urgent health problem facing the country, outstripping concerns about access to care (17%) and obesity (8%). This is the highest level of concern about cost since 2004, and just a hair shy of the all-time record set in 1992, as reported by Gallup.
“Satisfaction with U.S. healthcare costs is the lowest Gallup has recorded in annual trends since 2001, as 16% now say they are satisfied,” Gallup noted, highlighting a record low in public contentment. While 57% of Americans express satisfaction with their own health care costs—a figure that’s held steady for years—only 16% are satisfied with the overall cost of care in the country. That’s a steep drop from the 30% satisfaction seen at the start of the pandemic, underscoring how quickly optimism has faded.
The urgency of the moment is heightened by looming policy changes. The ACA’s enhanced premium subsidies, which help make marketplace health insurance plans affordable for millions, are set to expire on December 31, 2025. If Congress fails to act, the average premium for those plans could more than double, according to the Center on Budget and Policy Priorities and Kaiser Family Foundation. That means millions could face a financial shock come January—unless lawmakers intervene.
Yet, as the deadline approaches, Congress appears paralyzed. The House of Representatives is scheduled to vote on the Lower Health Care Premiums for All Americans Act, a Republican-backed proposal that, notably, does not extend the ACA subsidies. Speaker of the House Mike Johnson (R-LA) defended the bill, asserting, “House Republicans are tackling the real drivers of health care costs to provide affordable care, increase access and choice, and restore integrity to our nation’s health care system for all Americans.” He added, “Republicans are offering clear, responsible alternatives that will lower premium costs and increase access and health care options for all Americans.”
But House Minority Leader Hakeem Jeffries and his Democratic colleagues are not impressed. Jeffries slammed the GOP bill for failing to seek bipartisan consensus and announced his intention to vote “no.” House Democrats have countered with a proposal for a three-year extension of the ACA’s enhanced tax credits, but as of press time, the measure lacked the signatures needed to bring it to a vote on the House floor.
Over in the Senate, the partisan divide is just as sharp. On December 11, 2025, Senate Republicans filibustered a Democratic bill that would have temporarily extended the ACA’s premium subsidies for three years. The vote—51-48—fell strictly along party lines, with no Republicans supporting the measure. The defeat is consistent with a long-standing pattern: as reported by multiple sources, Republicans have spent more than a decade pushing to repeal the ACA and have resisted efforts to shore up its provisions, including those related to affordability.
President Donald Trump’s administration, in passing the “One Big, Beautiful Bill,” set the stage for the current crisis by allowing the ACA subsidies to expire at the start of 2026. Trump has repeatedly dismissed concerns about affordability, suggesting that Democrats have exaggerated the issue. However, as polling data show, Americans across the political spectrum are feeling the pinch—and they’re not buying the notion that cost concerns are a partisan invention.
The partisan split extends well beyond Capitol Hill. According to Gallup, 81% of Democrats and 64% of Republicans now agree that the health care system is in crisis or has major problems. Notably, Democrats’ concern has surged by 10-12 percentage points in the past year, while Republicans’ worries have also increased, albeit by a smaller margin. Independents’ views, meanwhile, tend to mirror those of the general population.
Despite the deep divisions, there is one area of broad agreement: most Americans believe the federal government should play a role in ensuring health care coverage. Gallup’s survey found that 64% of adults think it’s the government’s responsibility to make sure all Americans have health insurance—the highest level of support since 2007. Yet, when it comes to the shape of the system itself, the public is nearly evenly split: 48% favor a private insurance-based system, while 46% want a government-run model. Among Democrats, 90% support government responsibility for coverage (with 67% favoring a government-run system), while just 26% of Republicans agree the government should ensure coverage for all.
These numbers highlight the complexity of the debate. While Americans are clamoring for relief from rising costs, many remain satisfied with their own coverage—65% rate their own health care coverage as excellent or good, even as only 24% say the same about the system nationally. This paradox reflects a system where individual satisfaction can coexist with collective anxiety, especially as headlines about premium hikes and legislative gridlock dominate the news cycle.
The stakes could hardly be higher. If Congress does not act by year’s end, millions of ACA subscribers could see their premiums double. The resulting backlash could reshape the political landscape in 2026 and beyond. As the clock ticks down, Americans are watching closely, hoping for a breakthrough that will bring some measure of stability—and affordability—to a system that, for now, seems to be teetering on the brink.
With public satisfaction at record lows and the cost of care looming as the nation’s top health problem, the coming weeks could prove decisive for both policymakers and the millions of Americans whose financial and physical well-being hangs in the balance.
