Health care costs rank ahead of Americans’ money-worries about low wages and availability of cash, paying for college, house payments, taxes, and debt, according to the latest Gallup poll on peoples’ most important family financial problems in 2019.

Medical costs have, in fact, ranked at the top of this list for three years in a row, with a five percentage point rise between 2018 and 2019. No other financial concern had that growth in increase-of-money-worries in the past year.

Health care costs rank the top financial problem for people across all income levels. One in five families (19%) earning under $40,000 name medical spending as the most important financial challenge; 17% of families making $100,000 or more also say health care costs are their top financial concern. Many fewer affluent families are concerned about access to cash or the cost of housing compared with lower-income families.

By age, it’s the oldest group of Americans most concerned about health care costs: 23% of people 65 and older rank medical spending as their top financial problem. The next greatest response at 8% is lack of money and the cost of living (inflation) — people in retirement would indeed be concerned about living on fixed incomes over time.

At the other end of the age spectrum, only 11% of people 18-29 years of age cite health care costs as #1; for them, it’s low wages and lack of money, and housing costs, that rank highest — although quite close to health care costs (13% for cash versus 12% for housing vs. 11% for medical costs).

People 50-64 years old also rank health care costs at the top of their money concerns, twice as many saying so (25%) compared with the second highest response, lack of money/low wages (12%).

Gallup concludes, “Even in generally good economic times, Americans still face significant personal financial challenges. Foremost among these are healthcare costs, which have been a consistent concern over time but currently stand above all other concerns. As such, healthcare will likely continue to be a major focus in national elections, including the 2020 presidential election. Older Americans, who are more likely to need healthcare and who are more likely to vote than younger Americans, may pay special attention to what the candidates’ plans are for addressing healthcare costs.”

Health Populi’s Hot Points: I wrote the book, HealthConsuming: From Health Consumer to Health Citizen, based on Americans’ growing concerns about health care costs crowding out other line items in their family budgets — in particular, housing in much of the U.S. is becoming a huge barrier to financial wellness, and student debt, which is fastest-growing among older adults taking on debt for their kids and grandchildren.

We’ve noticed a growing and unsettling trend among at least one-third of working-age people raiding their retirement savings’ 401[k] plans to pay for current health care spending. This is worrisome because Fidelity Investments’ latest calculations in April 2019 gauged that people retiring in 2018 at 65 will need $285,000 to cover medical costs in retirement.

For context, the average savings in Fidelity’s portfolio of 401[k] accounts was $103,700 in the first quarter of 2019.

I concur with Gallup’s assessment that 2020 will be a health care election based on peoples’ visceral reactions to surprise medical bills, growing deductibles and co-payments, and financial toxicity as a side effect to special drug costs and EpiPens.