JACKSONVILLE, Fla. — Concerns are mounting among Americans about the affordability of healthcare as federal tax credits are set to expire, while medical expenses continue their upward trajectory.

According to the latest Gallup poll, nearly half of the adult population is apprehensive about their ability to pay for healthcare in 2026, marking an unprecedented level of anxiety captured by the survey.

This anxiety is already evident in Jacksonville’s healthcare facilities.

Volunteers in Medicine, a free clinic catering to the city’s working uninsured, reports an increase in patients seeking their services. These individuals find themselves unable to manage the costs of premiums, copays, or prescriptions, despite technically being insured.

“The problem most people face isn’t a lack of insurance anymore, it’s under-insurance,” leaders at the clinic told First Coast News. Patients arrive with insurance cards but still can’t afford basic care.

For 20-year Jacksonville resident Maira Martelo, the rising costs are personal. 

She manages diabetes and high blood pressure and says her insurance premiums have jumped dramatically.

“It makes no sense that we are one of the most developed countries in the world and that people are dying because they don’t have the basic care,” Martelo said.

Martelo says she has postponed retirement just to continue paying for necessary medications.

“I went from paying $1,200 a month to now $1,600 a month next year, which is outrageous,” she said. “That’s just for my primary care routine visits.”

One major driver: Affordable Care Act tax credits, which lower monthly premiums for millions, are set to expire in 2026 unless Congress extends them. Demands by Democrats to extend the credits were the main driver behind the longest U.S. government shutdown in history, which ended in November.

That looming deadline is already trickling down to families.

Volunteers in Medicine CEO Jennifer Ryan says their phones have been ringing nonstop.

“People are calling us in desperation. They can’t afford their premiums, copays, or even their medicine,” she said.

Ryan says the crisis is impacting people who appear financially stable on paper.

“About 40% of the people we serve make around $50,000 a year — and they’re living paycheck to paycheck,” she said. “They’re trying to pay their rent, stay in their home, provide childcare for their children.”

Health experts warn that when care becomes unaffordable, many people simply skip it, sometimes for years.

“Instead of getting yearly screenings, people are saying, ‘I’m not going to have health insurance. I’ll just wait until something happens,’ and that’s not a way to live,” Ryan said.

The consequences are already visible.

“People are showing up sicker, going to the emergency room, and then the ER sends them to us. But they’re really, really sick,” she said.

For people who delay care until emergencies arise, the financial fallout can be devastating, even with insurance.

Martelo, who documents medical debt stories professionally, says she hears it daily.

“I hear about people who have insurance but go into bankruptcy after an emergency visit,” she said. “People say, ‘Don’t take me to the ER unless I faint,’ because they can’t afford it.”

Volunteers in Medicine says it is urging people to get screened early, understand their benefits and seek help before conditions worsen.

As Congress debates the future of ACA subsidies, clinics like this one expect demand to continue rising, along with the anxiety so many Americans are already feeling about the cost of staying healthy.