Healthcare Under Trump Branded 'In Crisis' by Record Number of Americans

A record 23% of United States adults now say the national healthcare system is in a state of crisis, according to newly released data from the West Health-Gallup Health and Healthcare Survey, underscoring widespread public concern about affordability and access under President Donald Trump's administration.

The survey, conducted from Nov. 3 to Nov. 25, 2025, found that an additional 47% of respondents describe the system as experiencing 'major problems', marking a combined 70% of adults expressing deep unease about healthcare in the US. Only a minority believe the system has minor problems or no problems at all. The polling results come as key subsidies under the Affordable Care Act (ACA) approach expiration, potentially raising premiums for tens of millions of Americans.

Record High Perception of Crisis Amid Cost Pressures

The West Health–Gallup poll's topline results show a marked shift in public perception in recent years. In the November 2025 survey, 23% of respondents said the US healthcare system is in a 'state of crisis', the highest level recorded since Gallup began tracking the question. A further 47% said the system has 'major problems'.

Responses by political affiliation also point to broad bipartisan concern. The data show that significant shares of both Republicans and Democrats view the healthcare system negatively, with many citing either a crisis or major problems across ideological lines.

Healthcare affordability emerged as a dominant concern. According to the survey, 29% of respondents identified cost as the most pressing healthcare issue, reflecting growing financial strain on households. Cost concerns are among the highest levels recorded in the survey's history.

The Gallup topline release also shows that satisfaction with the cost of healthcare dropped to 16%, a low not previously observed in the Gallup trend, while personal satisfaction with one's own healthcare costs remained higher but was not sufficient to offset broader systemic concerns.

Health policy analysts view these figures as reflective of long-standing issues in the US healthcare model, where high national costs coexist with uneven outcomes and rising premiums, particularly as policy discussions over ACA funding and subsidies intensify in Washington.

Affordability and Policy Context

The West Health-Gallup findings come as expanded health insurance premium tax credits under the ACA are set to expire at the end of 2025, a change expected to significantly increase costs for many Americans. Although the House of Representatives had considered legislation to address premiums, ongoing legislative disagreements have slowed efforts to extend subsidies.

The expiration of these incentives could see premiums for subsidised plans jump substantially, potentially more than doubling for some consumers starting in 2026. Such changes compound public frustration and contribute to perceptions of systemic crisis, health economists say.

Broad dissatisfaction with how the federal government addresses healthcare costs mirrors other measures in the survey data. While the poll did not directly ask respondents whether blame lay with specific political leaders, the timing of the poll during Trump's tenure and amid policy negotiations in Congress situates public discontent in the context of current governance.

Additional surveys released this year reinforce the narrative of affordability strain: a national survey from April 2025 reported that 38% of Americans postponed or skipped necessary medical care due to expense, highlighting how financial barriers to care are widening.

Impact on Americans' Healthcare Experience

Despite rising concerns about national healthcare, individual experiences of care and coverage tell a more nuanced story. The West Health-Gallup survey toplines and related data show that many Americans continue to report satisfaction with their own healthcare coverage even as perceptions of the system's broader performance falter.

Yet the gulf between personal satisfaction and national system evaluations is striking. Individuals may feel relatively secure in their own plans while simultaneously holding negative views of nationwide affordability and access.

Cost remained the most frequently cited urgent health concern in the Gallup poll, far outpacing issues such as access or specific health conditions, with 29% ranking cost as the top problem. This focus on financial strain aligns with broader economic anxiety among households, especially as out-of-pocket costs continue to rise.

Policymakers on both sides of the aisle have called for reforms to address affordability, though proposals differ sharply on mechanisms and scope. Republican lawmakers have discussed alternatives to ACA extensions, while some Democrats advocate broader public coverage options, including enhanced government involvement in drug pricing and insurance markets.

The new Gallup survey places healthcare at the forefront of voter anxiety just as policymakers confront critical cost and subsidy decisions that may reshape access in the coming year.