The Asclepius Initiative's U.S. Health Care Coverage Survey
What Kentuckians Think of U.S. Health Care Coverage
Every two years, The Asclepius Initiative (TAI) surveys Kentuckians to learn more about their experiences with health care coverage and their views of the U.S. health care system. The 2026 Health Care Coverage Survey is TAI’s third, following surveys conducted in 2022 and 2024, examining the attitudes, beliefs, and experiences of Kentucky adults, including the challenges they face getting and using coverage, the effects of health care costs, and their views on how health care coverage should work.
The surveys tease out differences based on factors such as age, race and ethnicity, income, employment, political affiliation, type of health care coverage, and whether participants live in urban or rural communities. Questions address cost and other barriers to coverage and care, the connection between health care coverage and employment, whether Kentuckians believe that health care is a basic human right, and support for different approaches to providing coverage.
The 2026 survey was conducted online in English by NORC at the University of Chicago between May and June 2026. The final sample included 1,080 participants and combined NORC’s AmeriSpeak® probability-based panel with a non-probability sample. Survey weights were applied to more closely reflect Kentucky’s population.
The final sample included 1,080 participants and combined NORC’s AmeriSpeak® probability-based panel with a non-probability sample. Survey weights were applied so the 2026 results would more closely reflect Kentucky’s population.
Because the survey methods changed in 2026, comparisons with TAI’s 2022 and 2024 surveys should be viewed as descriptive trends rather than statistical comparisons. The earlier surveys used a different sampling approach and were not weighted.
Explore TAI’s 2026 findings below to see what Kentuckians have to say about health care coverage, costs, access, and the future of the U.S. health care system.
2026 U.S. Health Care Coverage Survey Highlights
Health Care Coverage At a Glance
These results provide a snapshot of the health care coverage Kentuckians have, how they choose it, and how they understand and use it. The questions probe insurance status and coverage type, what people pay, how they choose a plan, and the challenges they experience when trying to understand or use their benefits.
Most Kentuckians surveyed have health care coverage, but the results show important differences in who is uninsured and the types of coverage people rely on. Overall, 7.5% of survey participants were uninsured, with higher uninsured rates among Black, Asian, and Hispanic participants than among white participants. Those living in rural areas were also almost twice as likely as urban participants to have Medicaid as their primary coverage.Â
Obtaining and understanding coverage can be difficult. The cost of premiums was the most frequently reported challenge to obtaining coverage, cited by 36.4% of participants. When asked about understanding their benefits, 39.4% said it was difficult to know what health care would cost before receiving services. Among those who did not use their coverage during the past year, 32.8% feared their plan would not adequately cover what they needed, while 30.8% cited the cost of care or medications.
Health Care Costs
These results show how health care costs affect Kentuckians’ access to care and their household finances. They reflect how often people skip or delay care and medications because of cost, struggle to afford other necessities, worry about health care expenses, and feel about what they pay for premiums and out-of-pocket costs.
Health care costs continue to affect whether Kentuckians get the care and medications they need. Overall, 51.6% of participants reported avoiding, skipping, or delaying medical care or medications because of cost. Among uninsured participants, that figure rose to 95.4%, compared with nearly half (48.1%) of those who were insured. The findings also show significant differences by race and ethnicity.
The financial effects extend beyond medical bills. Nearly one-quarter of participants (24.6%) reported being unable to buy food or clothing because of medical costs, and 46.3% worried about health care expenses at least once a month. More than one-quarter (26.8%) anticipated being unable to afford their health insurance premiums in the coming year. Participants also reported dissatisfaction with both monthly premiums and the out-of-pocket costs they pay when they need care.
Universal Health Care
These results demonstrate Kentuckians’ views on health care as a human right and support for a national health care coverage program. They also show what people value in such a system, what concerns they have, and how factors such as cost, provider choice, benefits, taxes, and employment shape their opinions.
Kentuckians expressed broad support for the idea that health care is a basic human right and for a national health care coverage program. Nearly eight in 10 participants (79.2%) agreed that health care is a basic human right, while 72% supported a national program that would provide health care coverage for everyone. Support for health care as a human right crossed political lines, with 66.4% of Republicans and 92.2% of Democrats expressing this belief.
Cost, access, continuity, and choice were important in shaping views of a national program. Participants emphasized the importance of affordable, reliable coverage, making care more efficient and less complicated, and improving the quality of care. More than two-thirds (68.3%) agreed they should be able to change jobs and keep their health care coverage, and 85.7% agreed insurance should include dental, hearing, and vision care. Participants also expressed concerns about increased taxes, government involvement, implementation, and other potential negative effects of changing the current system.
Federal and State Policy Changes
These questions explore Kentuckians’ experiences and expectations in response to federal and state health care policy changes. They examine changes in premiums and out-of-pocket costs, concerns about access to care and Medicaid coverage, and views on new Medicaid work requirements.
Recent federal and state health care policy changes are contributing to concerns about the future cost and availability of coverage. Nearly half of participants (47.8%) reported that their premiums had increased compared with the previous year, and 46.7% expected their out-of-pocket costs to increase.
Participants also expressed concern about access to care and Medicaid. Nearly one-third (32.5%) believed it would be harder for their household to get the medical care they need, and among participants with Medicaid, 31.8% anticipated that they or someone in their household would lose Medicaid coverage in 2026. Views on new Medicaid work requirements were mixed and varied by political affiliation: 50.7% of Republicans supported the requirements, compared with 29.5% of Democrats.