New survey shows worries loom large over safety net programs and health care affordability in the US

Concerns over the potential insolvency of Medicare among those under 65 have risen, with 73% now expressing worry that it won't be available when they need it, up from 67% in 2022, according to the new West Health-Gallup 2024 Survey on Aging in America. Worry rose most among those aged 50 to 64, up 13 percentage points to 74%. Higher percentages of adults express concern about the future of Social Security, with 80% of people under 62 and 86% of people aged 40 to 49 fearing it will not be around once they are eligible.

According to the annual Social Security and Medicare Trustees Report released last month, there is cause for concern. Medicare's hospital insurance trust fund is forecast to be depleted in 2036 and Social Security's trust funds are expected to run dry in 2035, making the programs unable to pay full benefits to retiring Americans.

"Threats to Medicare and Social Security loom large, and people are worried policymakers won't do enough to protect and strengthen them," says Timothy Lash, President, West Health, a nonprofit focused on health care and aging. "These safety net programs are part of the fabric of aging that millions of older Americans rely upon, so any potential disruption or question mark around them is cause for alarm and deserving of greater attention and action from policymakers."

Most Americans do not think the government prioritizes issues affecting older adults. When asked in the survey how much the government prioritizes issues affecting older Americans, 74% say "not very much" or "not at all." This sentiment is felt by 80% of those 65 and older. Over half (57%) of Americans report they are either "somewhat more likely" (37%) or "much more likely" (20%) to support a candidate for public office that makes issues affecting older Americans a top priority. This sentiment increases with age, peaking at 77% among those aged 65 and older.

Two-thirds of Americans feel the country is not prepared to address the overall needs of its increasingly older population. By 2034, the U.S. Census Bureau projects, there will be more Americans aged 65 and older (77 million) than under the age of 18 (76.5 million), a first in U.S. history and making up nearly a quarter of the entire population.

"The fact that such a large percentage of U.S. adults observe little prioritization of issues affecting older Americans underscores the extent to which such prioritization could influence voting preferences, particularly among those already eligible for the federal safety net programs and those that will be soon," says Dan Witters, Research Director of the Gallup National Health and Well-Being Index.

But the Survey on Aging in America finds it's not just the future people are worried about—they're struggling now. An estimated 72.2 million—or nearly one in three adults—Americans have not sought needed health care in the last three months due to the cost, including 8.1 million Americans aged 65 and older. Nearly one-third (31%) are concerned about their ability to pay for prescription drugs in the next 12 months, up significantly from 25% in 2022. This concern is rising even faster among older Americans, who experienced an 11-point increase from 20% to 31% in the last two years.

Mental health challenges have also emerged as a key issue for Americans. Over one-quarter (28%) report that their mental health has worsened over the last three years. Among older Americans, those aged 65 and above, one-fifth report that their mental health has worsened (21%) compared to just 17% that said it has improved.

"Americans are clearly worried about what the future holds for them as they grow older. Will Social Security and Medicare still be around? Will they be able to afford their medical bills? Will the government help address their concerns?" says Shelley Lyford, Chair and CEO, West Health. "The answer to all these questions should be yes, and policymakers should act quickly to give Americans something to vote for and less to worry about."

Methodology

Results are based on a survey conducted by both mail (focused on older Americans) and the web from Nov. 13, 2023, to Jan. 8, 2024, with 5,149 adults aged 18 and older, living in all 50 U.S. states and the District of Columbia as a part of the Gallup Panel. Panelists aged 65 and older were oversampled to increase the stability of results for this segment of the population.

For results based on this sample of national adults, the margin of sampling error at the 95% confidence level is ±1.7 percentage points for response percentages around 50% and is ±1.0 percentage points for response percentages around 10% or 90%, design effect included. For reported age subgroups, the margin of error will be larger, typically ranging from ±3 to ±5 percentage points.