Healthcare Costs Straining People Across U.S.

Healthcare costs straining people across U.S.

Millions of Americans are struggling to pay for healthcare, and rising insurance costs may be pushing some people out of coverage altogether.

Nearly half of working-age adults had issues affording care last year, according to a June 10 brief from the Urban Institute. About 35% said someone in their family went without care they needed because of costs and about one-third reported medical debt. Nearly 17% said they had trouble paying medical bills.

Some people reported greater difficulties than others. More than half of Black and Hispanic adults said their families struggled to afford care, compared with about 42% of white adults. About half of adults who lived in the South and in rural communities also reported affordability problems.

Researchers also found signs that healthcare costs are rising. About one-third of adults with marketplace coverage said their health insurance premiums significantly increased during the previous year, nearly twice the rate reported by people with employer-sponsored coverage.

Those higher costs may already be affecting health insurance coverage, according to an analysis by Georgetown University researchers published June 8 on the Commonwealth Fund’s To the Point blog.

Some consumers may be dropping health insurance coverage they signed up for on the marketplace as premiums rise, the researchers said. Early data from several states showed sharper-than-usual declines in enrollment between open enrollment and April, suggesting more people canceled coverage or failed to pay their monthly premiums.

Pregnancy harms predicted to climb with higher temperatures

Thousands more pregnancy and birth complications are predicted to occur each year in the U.S. as the nation heats up with climate change. A new study, published June 4 in GeoHealth, finds that rising temperatures combined with humidity could lead to substantial increases in preterm births, stillbirths and low birth weight.

Researchers examined how increases in apparent temperature — a measure that combines heat and humidity and reflects how hot conditions feel to people — could affect pregnancy outcomes during the warmest months of the year in the continental U.S. They focused on levels of warming that are likely to be reached this century.

For every 1.8 degrees of warming, 420 additional stillbirths would occur each year, as compared with climate conditions from 1986 to 2005, the research projected. About 4,500 more babies would be born preterm and 3,800 more babies would have low birth weights.

At 7.2 degrees of warming, researchers projected about 22,000 more preterm births, 18,000 more babies with low birth weights and 2,000 additional stillbirths annually. 

The largest projected increases were concentrated in parts of the South and Gulf Coast, including Louisiana, Mississippi, Kentucky, South Carolina, West Virginia and the District of Columbia, where rates of maternal and infant health problems are already among the nation’s highest, the researchers said.

Previous research has shown hotter, more humid conditions increase risks during pregnancy. Hormonal and physiological changes during pregnancy can make people more sensitive to heat and reduce the body’s ability to regulate internal temperature, researchers noted.

Survey finds large knowledge gap for Medicaid work requirements

Millions of Medicaid users are in the dark about new requirements they’ll need to fulfill to keep their coverage, a new survey says.

Released June 6 by the Health Management Academy, the survey found that more than half of Medicaid beneficiaries were unaware that work requirements will become a condition of eligibility beginning next year.

Researchers surveyed nearly 2,000 adults enrolled in Medicaid nationwide in April. About 55% said they did not know that adults ages 19 to 64 enrolled under Medicaid expansion will be required to complete 80 hours a month of work, education, job training or community service to maintain coverage. Another 27% said they had heard about changes but weren’t sure about the details.

Many respondents said they’d be forced to make cuts in care if they lost Medicaid coverage. About 60% said they would stop routine doctor visits, while 41% said they would ration medications. A similar share said they would stop filling at least one prescription, including those for mental health, blood pressure, cholesterol and diabetes.

Responses varied by state. Lack of awareness of work requirements was highest in Oregon, New Hampshire, Idaho, New Mexico and Texas. In Nebraska, which has become the first state to implement the new requirements, half of Medicaid users were unaware of the changes.

About 20 million people nationally will be subject to the Medicaid work requirements, with more than 7.5 million people predicted to lose coverage as a result. States are required to begin outreach to Medicaid users about the changes by June 30.

Warming climate may fuel disease, disasters, pollution in California

From heavier storm rains to expanding dengue risk, climate change is reshaping California’s health, new research suggests.

Tropical cyclones could bring heavier rainfall to Southern California in coming decades, increasing landslide risks across the region, according to a new study published June 10 in Nature Climate Change. Researchers found that warming ocean temperatures and increased atmospheric moisture may make extreme rainfall events during tropical storms about twice as likely.

The study was inspired in part by Hurricane Hilary, which struck Southern California in 2023 and caused flash flooding, landslides and more than $900 million in damage. Historically, storms capable of producing at least four inches of rainfall have been considered once-in-a-century events in California. But the new research found storms that size could occur more often, bringing more damage with them.

Southern California counties especially would see growth in landslide-prone areas between 2000 and 2050, researchers predicted. 

Warming temperatures may also increase risks from infectious diseases for California residents. A June 11 study in The Lancet Regional Health Americas finds climate change is making parts of the state increasingly suitable for dengue fever, a mosquito-borne illness that can cause high fever, severe pain and even death.

Researchers found that about 18 million people live in areas with conditions that are already hospitable for local dengue transmission, including parts of Southern California and the Central Valley. That number could grow by more than 4 million as temperatures rise and habitat expands for the type of mosquitoes that spread the virus.

Climate change has also contributed to more severe wildfire conditions in California, with fire seasons starting earlier and lasting longer, larger areas burned, and increased wildfire risk in and around populated areas. Wildfire smoke has increased in recent years, contributing to more days with poor air quality across a larger share of the state.

New research published June 11 in Science suggests prescribed burns may help reduce that pollution over time. Deliberately burning 500,000 acres of California conifer forests annually could reduce cumulative wildfire smoke pollution by about 10% over a decade, scientists said.

But as prescribed burns also generate smoke, air pollution would initially increase. Researchers estimated the benefits would outweigh the risks within four years.

Other recent public health news of note:

• Hundreds of thousands of U.S. children are losing access to food assistance, according to a recent analysis from the Center on Budget and Policy Priorities. The number of children receiving benefits through the Supplemental Nutrition Assistance Program, also known as SNAP, fell by nearly half between July 2025 and spring 2026, data from 12 states showed. The largest drops were reported in Arizona and Texas. Researchers said changes under a 2025 federal law may be making it harder for eligible families to receive benefits. 

• About 15% of current global warming is being driven by pollutants that are largely missing from climate policy, according to a June 11 study in Science. Known as indirect greenhouse gases, the pollutants include carbon monoxide, nitrogen oxides and molecular hydrogen. Researchers said the pollutants have largely been left out of climate policies because their warming effects were not fully understood when international climate agreements were first developed decades ago.

The Watch is written by Michele Late, who has more than two decades of experience as a public health journalist.