Workers' Financial Security Hits 7-Year Low as Many Skip Care Over Cost

Financial security among American workers has fallen to its lowest level in seven years, and roughly a third of employees say they skipped or postponed a medical or dental appointment over the past year because of cost, despite having health insurance through their jobs, according to a survey of 6,000 U.S. employees released this week by the benefits consultancy WTW.

The findings land alongside new federal data showing that wealth gains over the past three years have flowed disproportionately to older Americans, and a separate retirement-industry survey finding that even affluent retirees are often too anxious about running out of money to spend what they have saved. Taken together, the three reports describe a widening gap between the financial pressures facing working-age Americans and the assets held by those already retired.

A Seven-Year Low

The share of employees who describe themselves as financially secure dropped from 46% to 36% in 2026, the lowest reading WTW has recorded in its benefits-attitudes research since 2019. The decline cut across income levels and job types, but it was not evenly distributed by age. Workers in their 40s reported the weakest financial footing of any group, with only 30% calling themselves financially secure, compared with roughly half of employees 60 and older.

Cost-related avoidance of care tracked a similar pattern. Across all age groups, close to one in three employees reported putting off or skipping a medical or dental appointment in the past year because of what it would cost, even though all of them had employer-sponsored insurance. Among workers in their 40s, that figure exceeded 40%, the highest of any age cohort in the survey.

High Deductibles, Thin Margins

The pattern is consistent with broader, federally tracked trends in cost-related care avoidance. A long-running federal health survey has for years tracked the share of American adults who delay or forgo medical care, prescriptions or dental visits because of cost; the most recent federal estimate put the share of adults who went without needed medical care due to cost at roughly 7% nationally, even before accounting for people who merely delayed rather than skipped care outright. Employer-sponsored insurance has not insulated workers from that dynamic: average deductibles and out-of-pocket maximums have climbed steadily over the past decade, even as premiums have risen as well, leaving many insured workers facing substantial bills before coverage fully kicks in.

Courtney Stubblefield, a health and benefits practice leader at WTW, said the plan designs many employers rely on to hold down premium costs are increasingly discouraging the very care they are meant to cover.

"Those kinds of features are becoming barriers to them getting the care they need," Stubblefield said.

Those features, Stubblefield said, include higher deductibles and narrower provider networks that shift more of the upfront cost onto employees, even when their coverage is otherwise comprehensive on paper.

Mid-Career Workers Squeezed Hardest

The survey's starkest finding involves workers in their 40s, who reported both the lowest financial security and the highest rate of forgone care. Stubblefield attributed that to the position many of those workers occupy in what researchers call the "sandwich generation," simultaneously supporting children and aging parents while carrying family health coverage, which costs considerably more than individual coverage.

"They have peak levels of obligation in that decade," Stubblefield said, describing a convergence of mortgage or rent payments, childcare or college costs, elder care responsibilities and retirement saving that leaves little room for unexpected medical bills.

The financial strain is also coloring how employees view their own retirements. Roughly two in three employees surveyed said they expect to be worse off financially in retirement than their parents' generation, citing healthcare costs as a primary reason. That pessimism is notable given that, by one broad measure, American households have grown wealthier overall. The Federal Reserve's latest Survey of Consumer Finances, released October 9, found that median family net worth rose 2% between 2022 and 2025 and mean net worth rose 7%, but those gains were heavily concentrated among older households already holding substantial retirement and investment assets.

Households headed by someone 75 or older, a group of about 18 million households, posted the highest median net worth of any age bracket, at roughly $504,000, while households headed by someone 65 to 74 saw their wealth climb 37% between 2022 and 2025, according to the central bank's full report on family finances. Younger households did not share proportionally in those gains, a divergence that mirrors the generational split in the WTW survey's financial-security findings.

Reluctance to Spend, Even Among the Wealthy

The flip side of that imbalance shows up in how little many older Americans are willing to draw down the wealth they have accumulated. A separate survey of retirees and pre-retirees conducted by Prudential Financial this fall found that only 14% of respondents felt comfortable spending their retirement savings each month on things they enjoy. Even among those with more than $500,000 in investable assets, 61% said they remained uneasy about discretionary spending, with many citing uncertainty over Social Security, inflation and future healthcare or long-term care costs as reasons to hold back.

The combination points to a lopsided picture of financial stress in 2026: working-age employees, particularly those in their 40s, straining to cover current medical bills on top of other obligations, while many retirees sit on accumulated savings they are reluctant to touch out of fear of running out later. Workers in the WTW survey did report improvements in physical health and social connection over the past year, suggesting the financial strain is not simply part of a broader decline in overall well-being, but a distinct and worsening pressure point.

What Happens Next

Employers are heading into open enrollment season for 2027 benefits with little indication that underlying cost pressures will ease. Health insurers have signaled further premium increases for next year, and nothing in the current data suggests deductibles or out-of-pocket maximums are likely to fall. WTW's research has increasingly been used by employer benefits teams to justify expanded financial-wellness programs, from student-loan assistance to emergency savings accounts, though those offerings have so far done little to reverse the broader slide in reported financial security.

For now, the data suggest that the gap between insurance coverage and actual access to affordable care remains wide for a significant share of working Americans, particularly those in their peak earning and spending years, even as the same group reports no shortage of coverage on paper.