Healthcare Affordability Deserves More Than a Mention

This week’s State of the Union included references to prescription drug pricing. The administration pointed to reductions in certain medication costs and promoted a “most favored nation” pricing model alongside a government-run platform designed to lower prices. The message was clear: progress is being made.

But here is the question we have to ask. Is it enough?

For Black women and families already navigating disproportionate health burdens, affordability is not a talking point. It is a daily calculation. It is the choice between refilling a prescription and covering rent. It is stretching insulin. It is delaying follow-up care. It is rationing what should never be rationed.

Yes, targeted reductions matter. Yes, any savings can help. But lowering the cost of a limited number of medications does not equal systemic reform. A platform that covers a small list of drugs does not transform a system where premiums, deductibles, and out-of-pocket costs continue to climb.

And those broader costs are rising fast.

According to analysis from the Johns Hopkins Bloomberg School of Public Health, health insurance premiums are increasing sharply across employer-sponsored plans and Affordable Care Act marketplace coverage. In many states, marketplace premiums are projected to rise by double digits this year. At the same time, enhanced federal premium subsidies that made coverage more affordable for millions are expiring, meaning many families could see their monthly costs jump significantly.

Today, nearly half of U.S. adults report difficulty affording healthcare costs. More than 4 in 10 say they have delayed or skipped medical care due to cost. High deductibles are now the norm, not the exception. Over half of workers with employer-sponsored coverage are enrolled in high-deductible health plans, which means even insured families often pay thousands out of pocket before coverage fully kicks in.

This is not just about premiums. It is about the entire cost ecosystem.

When families downgrade to cheaper plans with higher deductibles, they often delay preventive care and chronic disease management. When Medicaid funding tightens and marketplace costs rise, coverage gaps widen. When maternal health services come with steep out-of-pocket costs, financial stress compounds an already dangerous crisis for Black women, who face maternal mortality rates nearly three times higher than white women.

Healthcare affordability should not be a side note in our national conversation. It should be the headline.

We need structural solutions that address:

• The full spectrum of prescription drug pricing, especially for chronic conditions that disproportionately impact Black communities
• The rising cost of premiums and deductibles that make insurance feel out of reach even when people are covered
• Maternal healthcare expenses that leave too many families financially vulnerable
• The broader cost system that makes preventive care, mental health services, and reproductive care harder to access

Affordability is not just about price tags. It is about power. When healthcare is unaffordable, people delay care. When people delay care, outcomes worsen. And when outcomes worsen, disparities deepen.

We cannot talk about a strong economy while families are forced to crowdsource medical bills. We cannot celebrate progress while patients still ration medication. And we cannot declare victory while access depends on income.

If we are serious about strengthening families, healthcare affordability must move from being referenced to being reimagined. That means comprehensive reform that lowers costs across the board, stabilizes insurance markets, protects subsidies that expand access, increases transparency, and ensures that savings are meaningful and lasting.

Because healthcare should not be a luxury.

It should be a guarantee.