Variations in Health Care Affordability Between Households

Factors like household income and composition impact how a person navigates the health care system. For example, Oklahoma 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 Oklahoma in 2024 was $66,148.¹

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 (49% versus 27%). Still, over half of respondents living in higher income households also faced affordability issues, indicating that these burdens affect all income groups. 75% 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 Oklahoma 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, 16% 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 6% 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, Oklahoma respondents with a Bachelor’s or graduate degree reported experiencing a health care affordability burden less frequently than respondents with lower educational attainment. In contrast, respondents an Associate degree reported experiencing a health care affordability burden (83%), and a health care cost burden due to medical bills (57%) 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-two (2% of) respondents reported not getting needed medical care because they couldn’t find a doctor of the same background as them and twenty (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 68%); 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 68%). Additionally, females reported experiencing a cost burden due to medical bills more frequently than male respondents (44% versus 35%).

Respondents that identify as sexually diverse also experienced affordability burdens, with 49% reporting rationing medication due to cost compared to 29% 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

Over three in every four (79% of) Oklahoma 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 Oklahoma residents support, see: Oklahoma 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).