Transamerica Center for Health Studies is a national non-profit and thought leader empowering Americans to achieve the best health outcomes, value, and protection from their healthcare. In August 2018, our Sixth Annual Nationwide Consumer Healthcare Survey queried 3,604 American adults ages 18-64 to gauge how they perceive healthcare, health coverage and policy, their personal health, and how they manage medical expenses. Our survey results support public and private healthcare professionals looking to make informed decisions regarding healthcare policy, costs, and insurance.

Read the full report here and see the key findings below:


Healthcare costs are a major stress for Americans (62%), second only to money (72%). (pg. 117)

• Respondents said the ability to pay for needed care (35%) is the most pressing issue in healthcare. Nearly half (48%) said they received an unexpected or surprise medical bill they thought or were told would be covered by insurance. (pgs. 54, 83)

• One in five (17%) Americans cannot afford routine healthcare expenses, including prescription drugs. The vast majority of respondents (79%) feel pharmaceutical companies are responsible for high prescription drug prices. (pgs. 66, 86)

• Sixty-nine percent of US adults are paying for significant healthcare expenses through a variety of means, including savings (35%), credit cards (28%), disposable income (24%), loans from family (8 percent), or a 401k withdrawal (6%). Only 27 percent indicate they do not have significant healthcare expenses. (pg. 78, 88)

• A majority of Americans say their most important health related priorities are paying preventive healthcare expenses (56%) and self-care (55%). Sixty-one percent of employees say they are not offered a workplace wellness program. (pgs. 116, 122)

A majority of Americans (55%) are aware of potential changes to healthcare policy and are very or extremely concerned about them. (pg. 37)

• Overall, 62 percent of Americans report having a chronic illness and 35 percent of all adults fear losing coverage because of a pre-existing condition if healthcare law/policy changes. The most common health conditions reported were mental health-related (21%) and high blood pressure (19%). About half (45%) say they would want healthcare policy requiring pre-existing condition coverage included in healthcare policy. (pgs. 17, 47-48, 69, 113)

• About two in five (41%) have a positive view of the Affordable Care Act and thirty percent have a negative view. However, the majority (56%) do not believe the government should require (mandate) healthcare coverage, with the largest groups being white (60%) Baby Boomers (63%), and those living in rural areas (66%). (pgs. 29, 38, 40-41, 44)

The price of health insurance is rising and unaffordable for many. (pg. 22, pg. 59)

• Overall, about one in three Americans saw an increase in health insurance premiums (35%), out-of-pocket expenses (31%), and deductibles (29%). More than a third (35%) of Americans would want government limits on out-of-pocket expenses included in healthcare policy.  (pgs. 48, 59, 64)

• About one in three (35%) insured adults acquired new health insurance in the past twelve months. The majority (61%) of uninsured respondents say cost prevents them from obtaining health coverage. (pgs. 22, 24)

• About half (47%) report having to stay at their current job because they need the health insurance. Twenty-seven percent had to leave a previous job because the company did not offer health insurance. (pg. 46)

• Latinos (69%) are least able to afford health insurance and are by far the most uninsured (26%). African Americans report poorer health compared to last year. (29% vs 21%) (pgs. 14, 112)