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High healthcare costs force chronically ill patients to skip care, meds

Around half of people with one or more chronic illnesses have skipped or delayed care in the past year, and for a third of them, it was due to high healthcare costs.

Sara Heath
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Published: 16 Sep 2026

High healthcare costs, plus payer policies such as prior authorizations, are getting in the way of healthcare access for people with chronic health conditions, according to a new survey of more than 25,000 adults.

The report, completed by KFF, showed that nearly a third of those managing chronic illness have trouble affording their medical bills. Those high costs are leading folks to delay or even skip their medical appointments and are having an impact on medication adherence, both of which are core tenets of good chronic disease management.

"If the first obligation of a health care system is to take care of the sick, we are failing that test," Drew Altman, KFF founding president and CEO, said in a press release. "Cost and access problems are hitting the chronically ill hard, and the chronically ill and uninsured especially hard."

Folks with three or more chronic conditions -- such as cancer, lung disease, diabetes, cardiovascular disease or mental health conditions -- are among the most likely to report healthcare affordability challenges, with 36% saying as much. Likewise, people with cardiovascular disease (37%) and mental health conditions (36%) were among those most affected by high medical costs.

High costs delay care, impact medication adherence

High healthcare costs come with stark consequences, the survey showed.

For example, about half of adults with three or more chronic conditions said they've skipped or delayed care in the past year, and for a third of those adults, it was due to cost.

Cost also impacts medication adherence, with about 16% of those with one or two chronic conditions saying they've skipped or rationed a dose of their medications due to cost. This was even more common among those with three or more conditions (25%), folks with lung disease (25%) and those managing mental health conditions (25%).

It's not just cost that imposes barriers to care.

A fifth of people with complex chronic illness couldn't find a clinician with appointment availability, for example. Another fifth said they skipped care for other reasons aside from appointment availability and cost, such as certain social determinants of health.

Patients are facing the consequences of skipped or delayed care, with 18% of all patients with multiple complex chronic conditions saying this pattern worsened their health. This trend was most common among those with three or more chronic conditions (27%), mental health conditions (32%) and lung disease (29%).

The prior authorization effect

Perhaps not surprisingly, payer policies, like prior authorizations, have also contributed to healthcare access delays, the survey showed.

Overall, 30% of adults have experienced a coverage denial or treatment delay because of a payer policy. For those with one or two chronic conditions, that figure was 33%, and among those with three or more conditions, it was 49%.

Care denials and delays were also more common among those with cardiovascular disease (45%) and mental health conditions (47%). Regardless of disease state, the proportion of people reporting coverage denials or care delays from their payer was over one-third.

Sara Heath is an executive editor at Xtelligent Healthcare Media, where she covers patient engagement, healthcare policy and health IT.

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