The American Heart Association today released a Presidential Advisory declaring that health care affordability in the United States has reached a crisis point, with total spending approaching $5 trillion annually and projected to consume 20% of the nation's gross domestic product within the next decade. The advisory, published on April 30, 2026, warns that rising costs are forcing many Americans to delay or avoid care, worsening health outcomes and increasing medical debt.
According to the advisory, health care costs related to cardiovascular disease are projected to quadruple by 2050. A recent survey from Gallup indicates widespread concern about access and affordability, while a McLaughlin & Associates poll found that 51% of voters cite health insurance as their top health concern, followed by hospital bills (11%) and medicine costs (10%).
“Health care affordability is one of the defining challenges of our time,” said Dhruv S. Kazi, M.D., M.S., writing committee chair, director of the Cardiac Critical Care Unit at Beth Israel Deaconess Medical Center and Associate Professor at Harvard Medical School. “This advisory outlines core guiding principles for action to ensure everyone in this country has access to the care they need and the health care system is sustainable for generations to come.”
The advisory identifies key drivers of rising costs, including high prices for treatments and services, administrative complexity, underinvestment in prevention and public health, demographic shifts, and cost shifting to patients. Medical debt, a uniquely American problem among high-income countries, is a leading cause of personal bankruptcy.
To address the crisis, the American Heart Association proposes five core principles: ensuring access to high-quality care without financial hardship; minimal or no cost-sharing for high-value preventive services; shared accountability across the health care ecosystem for efficiency and transparency; strategic investments in workforce, infrastructure, and data; and strengthening public health infrastructure to address health inequities.
“Affordability is not just an economic issue – it is a health issue that directly affects lives,” said Nancy Brown, CEO of the American Heart Association. “By laying out clear, evidence-based principles for action, we are doubling down on our commitment to advance policies and solutions that improve access to care, strengthen prevention and build a more sustainable health care system.”
The advisory emphasizes that affordability cannot be addressed through cuts alone; strategic investments are necessary to improve outcomes while controlling long-term costs. The Heart Association encourages policymakers and stakeholders to use this advisory as a roadmap for meaningful action. The full advisory is available at heart.org, and additional resources include a video interview with Dr. Kazi.
