Affordability crisis hits US as healthcare, college fees soar

Achieving the "American dream" may take the painstaking toil of generations, yet it takes only two bills to shatter it: a health insurance premium and a college tuition statement.

For Yang Lin, a data scientist at a Bay Area tech company, this August feels particularly stark. Her daughter is heading to a private college this fall as a freshman while her husband has been out of work since last September. When their company-subsidized health insurance terminated, she shopped around the marketplace and got a monthly quote of $2,400. "Are you kidding me?" she said, adding her daughter's college tuition alone runs $70,000 a year, with another $20,000 for room, board, and a meal plan.

"I'm afraid we are going to go broke," she said quietly. A first-generation immigrant, Lin is now the sole breadwinner for a family of three in one of the most expensive states in the US. "We are a living example of the working American family squeeze," she told China Daily. "I don't have an American Dream. If I have one, it's this: give me affordable health insurance now."

Lin is not alone. Elevated healthcare expenses and the rising cost of living in recent years have become the new normal, and have chronically exerted financial strains upon millions of US families.

According to a survey in 2025 by the West Health-Gallup Center on Healthcare, about 11 percent of US adults admitted that they could not "afford or access quality healthcare", which involved nearly 29 million people, the highest level since 2021.

Classified as "Cost Desperate" in the study, the group is disproportionately made up of Hispanic Americans at 18 percent, black Americans at 14 percent, and households earning under $24,000 annually at 25 percent.

In her 2026 research, Munira Gunja, a scholar at the Commonwealth Fund, and her colleagues found that roughly 8 percent of the US population is uninsured. Due to high deductibles and out-of-pocket costs, Gunja found US citizens are far more likely than people in comparable countries to skip filling a prescription, avoid a diagnostic test, delay treatment, or abandon a care plan their doctor recommended.

Gunja concluded that the causes of the US' "uniquely poor health performance" relative to its peers include the absence of universal coverage, a weak primary care infrastructure, steep out-of-pocket costs, and an insurance system of bewildering complexity.

Amy Liu, a registered nurse at a Santa Rosa, CA-based medical facility, told China Daily that many patients she received during night shifts sought emergency care. It means hospitals are legally required under federal law to provide medical screening and stabilizing treatment, regardless of patients' insurance status or ability to pay.

"Both the patients and the hospitals understand that. I guess that is the only solution for some of the affected families to get some sort of medical assistance," Liu said. "But the cost will not go away. Ultimately, the taxpayers will foot the bill. I regret that the whole medical system is failing Americans, many of them."

Similarly, the college bill is another mountain that tens of thousands of US families are carrying uphill, one that has negatively affected public perception of the merits of undergraduate and graduate education.

"College education, especially (for those) attending high-ranking schools, has become a luxury only the rich and the elite can afford," said Yanzi Luo, a Michigan resident who had to persuade her son to decline an offer from Harvard and attend the University of Michigan instead. "It was a hard decision for the family to make, but the difference between $90,000 and $30,000 a year is reason enough to choose," she said.