The Real Cost of Health Insurance: Exploring Critical Challenges for U.S. Families

In February 2025, Count on Mothers examined U.S. families' experiences with health insurance affordability, coverage, and access to care. Drawing on a nationally representative survey of mothers across regions and the political spectrum, the study addressed five core questions: who drives healthcare decisions, rates of denied and delayed care, the administrative burden on families, differences between private and public insurance experiences, and the health and financial consequences for families. Findings describe systemic challenges in the current health insurance landscape — particularly among families with private insurance.

Administrative burden is widespread:
Nearly 65% of mothers report struggling with excessive paperwork and authorization hurdles to access essential care, with burdens more pronounced among families with private insurance.
Insurance companies often override medical judgment:
More than half of mothers (54%) say insurance companies exert more control over healthcare decisions than doctors, and 60% of these mothers report that their family’s health has suffered as a result.
Denied and delayed care cause real harm:
About 45% of mothers report that an insurance decision harmed their family’s health, and a similar share report being denied treatments they believed should have been covered.
Delays are strongly linked to negative health outcomes:
Among mothers forced to delay or forgo care due to insurance requirements, 72% report adverse health effects, compared with 22% among those who did not experience delays.
Private insurance is associated with worse outcomes:
Families with private—especially self-paid—insurance report higher denial rates, greater administrative burdens, and more frequent negative health impacts than those covered by Medicaid or Medicare.

Source: Count on Mothers, The Real Cost of Health Insurance: Exploring Critical Challenges for U.S. Families, February 2025. Nationally representative survey of 6,073 U.S. mothers across all 50 states and Washington, D.C., weighted across political ideology and region (sample composition compared to Gallup national averages and U.S. Census Bureau distributions). Research led by a PhD-credentialed researcher and an MPH data scientist.

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Count on Mothers conducts nationally representative research with U.S. mothers, weighted to reflect the population and reported in aggregate. Research is led by a PhD + MPH team. Findings have informed policy, industry, and media, and entered the Congressional Record on childcare, paid leave, and technology policy.

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