Summary

According to a survey of more than 1,400 Kansas adults conducted from August 1, 2025 – September 19, 2025, many residents have had inconsistent experiences accessing and affording the health care system in the past year. Among those respondents:

• Nearly 3 in 4 (74%) experienced at least one health care affordability burden in the past year;
• Nearly 4 in 5 (78%) worry about affording health care in the future;
• Respondents living in households that include a person with a physical or cognitive impairment ration medication due to cost more frequently than respondents living in households without a person with a physical or cognitive impairment (44% versus 24%); delay or go without care due to cost more frequently (83% versus 66%); and experience more cost burdens due to medical bills (63% versus 34%); and
• 29% of respondents of color skipped needed medical care due to distrust of or feeling disrespected by health care providers; and
• 53% of all respondents think that people are treated unfairly based on their race or ethnic background somewhat or very often in the U.S. health care system.

Variations in Health Care Affordability Between Households

Factors like household income and composition impact how a person navigates the health care system. For example, Kansas respondents in households earning less than $50,000 a year reported experiencing a health care affordability burden more frequently than wealthier households (see Table 1). The median household income in Kansas in 2023 was $75,514.¹

Respondents that earn less than $50,000 annually also more frequently reported experiencing a cost burden due to medical bills, like incurring medical debt, depleting savings, or sacrificing basic needs like food, heat, or housing compared to those earning $100,000 or more annually (53% versus 32%). Still, over half of respondents living in higher income households also faced affordability issues, indicating that these burdens affect all income groups. At least 78% of respondents across all income levels expressed concern about affording health care now or in the future.

Similar to income, household composition can also influence the types of challenges that people are exposed to when navigating the health care system. People with a physical or cognitive impairment, for instance, interact with the health care system more often than others, which frequently results in greater out-of-pocket costs.² Kansas respondents with a physical or cognitive impairment, or who live with a person with a physical or cognitive impairment, reported experiencing an affordability burden or concern more frequently than other respondents (see Table 2).

Additionally, 15% of respondents with a physical or cognitive impairment, or who live with a person with a physical or cognitive impairment, reported that they or their household member delayed getting a medical assistive device such as a wheelchair, cane, walker, hearing aid, or prosthetic limb due to cost, compared to only 3% of respondents without a physical or cognitive impairment who may have required one of these tools for temporary support.³

Variations in Health Care Affordability Between Demographic Groups

Research has shown that demographic differences persist in self-reported health status, access and affordability.⁴ This survey also revealed variations in reported affordability burdens between demographic groups. For example, Kansas respondents with a Bachelor’s or graduate degree reported experiencing a health care affordability burden less frequently than respondents with lower educational attainment. Respondents without a formal education beyond a high school diploma or GED reported experiencing a health care affordability burden (83%), and a health care cost burden due to medical bills (51%) more frequently than other respondents (see Table 3).

Likewise, respondents of color reported higher rates of many affordability burdens compared to white alone, non-Hispanic respondents (see Table 4). A small share of respondents also reported unique challenges to care that were unique to their backgrounds. Thirty-one (2% of) respondents reported not getting needed medical care because they couldn’t find a doctor of the same background as them and 18 (1% of) respondents reported not getting needed care because they couldn’t find a doctor who spoke their language.  

Differences in the frequency of reported health care affordability burdens and concerns by sex also emerged in the survey results (see Table 5). Women reported higher rates of experiencing at least one affordability burden in the past year (76% versus 72%); more frequently reported delaying or forgoing care due to cost; and reported higher rates of rationing medications by not filling prescriptions, skipping doses, or cutting pills in half. Although many respondents expressed concerns about health care costs, a higher percentage of female respondents reported being worried about affording some aspect of coverage or care compared to male respondents (83% versus 72%), although the same percentage of male respondents reported experiencing a cost burden due to medical bills (both 43%).

Respondents that identify as sexually diverse also experienced affordability burdens, with 51% reporting rationing medication due to cost compared to 28% of respondents that are not a part of a sexual minority group (see Table 6). Members of these communities experience higher rates of disability and encounter unique challenges accessing health care and medications.^5,6,7

Trust and Respect

Negative experiences in the health care system can increase mistrust, and whether a patient trusts or feels respected by their health care provider may influence their willingness to seek necessary care.^8,9 In Kansas, 27% of respondents reported feeling that their health care providers never, rarely, or only sometimes treat them with respect, and 40% reported they were not confident in being able to find a doctor that they like or trust.

Overall, 39% reported distrust or perceived disrespect from their providers, and 21% went without care because of a lack of trust or perceived disrespect. Certain groups reported forgoing care at higher rates due to these experiences – while over a quarter (30%) of respondents enrolled in KanCare, the Kansas Medicaid program, reported going without care due to distrust or perceived disrespect, only 19% of individuals with employer-sponsored insurance reported the same (see Table 7).

27% of Kansas respondents reported feeling disrespected during a clinical encounter. When asked why they believe their providers did not treat them with respect, the most frequently cited reasons include: income or financial status (43%); disability (20%); race (19%); where they live (18%), gender or gender identity (12%); ethnic background (12%); and educational attainment (13%). In lesser numbers, some respondents also cited sexual orientation (7%) and their experience with violence or abuse (7%).

When asked to describe how their identities or circumstances have impacted their ability to access quality, patient-centered care respondents offered a variety of examples, including:

Negative experiences when seeking care can contribute to a lack of trust in the health care system, leading to poorer health outcomes and higher costs. Respondents reported that they believe that both individual practices and beliefs, as well as  policies and practices built into the health systems are factors can impede the quality of care received – in fact, fifty-three percent (53%) of respondents reported that they believe that people are treated unfairly by the health care system due to their race or ethnicity either somewhat or very often. When asked why, respondents most frequently cited policies and practices built into the health care system (13%), the actions and beliefs of individual health care providers (16%), and an equal mixture of both of these factors (42%).

Over three in every four (77% of) Kansas respondents agreed or strongly agreed that the U.S. health care system needs to change. Interestingly, there is bipartisan support for government-led solutions for more information on the types of strategies Kansas residents support, see: Kansas Residents Struggle to Afford High Health Care Costs; Worry about Affording Health Care in the Future; Support Government Action across Party Lines, Healthcare Value Hub, Data Brief (October 2025).