State of Patient Access scorecard finds that patients with chronic illness continue to face challenges accessing and affording healthcare
The PAN Foundation’s Center for Patient Research has released its 2025 State of Patient Access Report, which once again reveals that adults with chronic conditions across demographics face deep challenges accessing and affording needed healthcare and treatment.
Based on the second nationwide survey of its kind, conducted by The Harris Poll, patients answered questions about their access to care, resulting in a scorecard rating across five key categories, including:
- Overall Access to Care = C+ (78.9)
- Relationship with Healthcare Professionals = B (84.3)
- Affordability of Prescription Medications = B- (80.8)
- Access to Treatment through Healthcare Plans = D- (63.1)
- Financial Toxicity = D+ (68.8)
Key findings for 2025
Healthcare access and affordability is not getting better, and in some cases, is getting worse.
When compared to the scorecard ratings from the 2024 State of Patient Access Report, this year’s survey indicates that not much has changed in terms of patient access. In fact, most composite measures did not move materially between 2024 and 2025, reflecting significant and persistent challenges with healthcare access and affordability.
In a year-over-year comparison, Overall Access to Care, Relationship with Healthcare Professionals, and Access to Treatment through Health Plans nudged up slightly or remained essentially flat, but Affordability of Prescription Medications and Financial Toxicity declined.
Having health insurance does not guarantee access to timely, affordable healthcare.
The ability to Access Treatment through Health Plans earned a “D-” across all patients, once again coming in with the lowest overall grade across the five categories. Nearly half (48%) of insured patients with chronic diseases who take prescription medication(s) reported they had faced some form of insurance-related barrier to accessing their prescriptions. In addition, more than three out of 10 (35%) respondents who have a deductible as part of their healthcare plan said that deductible had been unaffordable in the past year.
Notably, the score for this category fell to a failing grade of an “F” among American Indian/Alaska Native, Hispanic, and LGBTQIA+ patients, highlighting the continued differences in health outcomes based on a person’s identity and the impact a patient’s identity can have on their ability to access care through their health plans.
Affordability of prescription medications continues to drop, with negative outcomes for patients.
Although the Affordability of Prescription Medications measure earned a “B-” again this year, the score dropped significantly from 82.3 in 2024 to 80.8 in 2025. Lack of affordability hits the following groups the hardest: Black/African American (“C,” 75.8) Hispanic (“C,” 74.0), American Indian/Alaska Native (“C,” 74.6), and Pacific Islander/Native Hawaiian (“C,” 75.2) people; people in the LGBTQIA+ community (“C,” 75.0); people living in the South (“C+,” 79.2) and in urban areas (“C+,” 77.6); uninsured people (“D+,” 67.2); people with rare diseases (“C,” 73.8), and people from Gen Z (“C,” 73.2) and Millennials (“C,” 74.0).
Overall, more than one in five (22%) patients who take at least one prescription medication said it was difficult to pay for prescriptions in the past year, and 23% of patients who had medication costs said that prescriptions were not affordable. One in five (21%) patients said they could not get the prescription they needed because of cost, putting their health at risk.
Our 2025 State of Patient Access Report suggests that healthcare access in the U.S. continues to be a challenge for far too many, pointing to a growing crisis that is likely to persist without concerted actions.”
– Amy Niles, Chief Mission Officer, PAN Foundation
Financial toxicity continues to represent a serious issue for many.
Patients rated the impacts of healthcare costs on their lives—Financial Toxicity—as a “D+,” dropping from a “C-” in 2024. Fully one in four (25%) patients said financial toxicity affects them a lot or a great deal, representing an increase compared with 2024 results (23%).
More than half (56%) of LGBTQIA+ respondents reported that they have experienced a lot or a great deal of financial toxicity due to the cost of healthcare, nearly double the proportion of non-LGBTQIA+ respondents (24%). Hispanic patients rated Financial Toxicity an “F,” and Black patients’ rating of Financial Toxicity dropped from a “D” to a “D-” when compared to 2024.
Across all measures, people experienced negative impacts based on personal identity characteristics.
Nearly two in five (38%) patients reported feeling that some aspect of their identity negatively impacts their ability to get the best possible care. Income, insurance status, and age are the most frequently cited factors, but people also noted the negative impact of factors such as location, employment status, race, disability status, education level, gender identity, sexual orientation, and religion. Throughout our research, we found differences among groups in nearly every category we investigated.
Medical debt is a leading concern among patients, impacting their overall wellbeing.
This year’s research also explored three new areas not included in the scorecard—Negative Impacts of Medical Debt, Patient Knowledge about Healthcare Plans, and Use of Technology in Healthcare. With regard to medical debt, two in five (40%) respondents reported having some amount of medical debt, averaging $729.
Of note, medical debt is unevenly distributed, with patients of color averaging $983 in current medical debt compared to $584 among white patients. For those patients with medical debt, most report that the debt had at least a little negative impact on their stress or anxiety (86%), challenges paying for living expenses (73%), timing of their treatment (67%), their credit score (65%), and their personal relationships (56%).
“Our 2025 State of Patient Access Report suggests that healthcare access in the U.S. continues to be a challenge for far too many, pointing to a growing crisis that is likely to persist without concerted actions,” said Amy Niles, Chief Mission Officer at the PAN Foundation. “While some of these findings may not be surprising, they reinforce the need for tangible, long-term policy solutions that help to accelerate and improve access to care. As a leading healthcare advocacy and education organization, the PAN Foundation will continue to work alongside patients, healthcare professionals, policymakers, and patient advocacy organizations nationwide to address barriers to care so that everyone has access to the care they need and deserve.”
All patients surveyed had been diagnosed by a healthcare professional with at least one chronic health condition. More than half (54%) had multiple chronic health conditions, with nearly one in ten (9%) having five or more conditions.
About the State of Patient Access Report
The State of Patient Access Report is a flagship research initiative of the PAN Foundation’s Center for Patient Research, aimed at exploring the challenges faced by patients when it comes to healthcare access, and their impact on different communities. Launched in 2024, this groundbreaking initiative uses a comprehensive national survey, conducted by The Harris Poll, to hear directly from adults with chronic health conditions.
PAN’s Center for Patient Research is dedicated to providing evidence-based insights that convey the diverse needs of patients as they navigate the healthcare system and challenges accessing affordable, equitable care. Through rigorous methodologies, the Center for Patient Research aims to understand the challenges faced by patients, translate these findings into actionable knowledge for healthcare stakeholders and policymakers, and help inform policies that lead to accessible, equitable, and affordable healthcare for all.
Methodology
The research was conducted online in the United States by The Harris Poll, on behalf of the PAN Foundation, among 2,723 adults age 18+ who reside in the U.S. and have by diagnosed by a healthcare professional with a chronic health condition (including 2,578 completes from the general population and race/ethnicity oversamples and 145 completes from the LGBTQIA+ oversample). The survey was conducted in English and Spanish between August 1 and September 2, 2024.
To assess the state of patient access in the United States into a scorecard, The Harris Poll, on behalf of the PAN Foundation, synthesized the patient survey results into a 2025 State of Patient Access Scorecard, organized across five key categories.
Take a closer look at our survey and scorecard methodology
About the PAN Foundation
As a leading charitable foundation and healthcare advocacy organization, the PAN Foundation is dedicated to accelerating access to treatment for those who need it most and empowering patients on their healthcare journeys. We provide critical financial assistance for treatment costs, advocate for policy solutions that expand access to care, and deliver education on complex topics—all driven by our belief that everyone deserves access to affordable, equitable healthcare.
Since 2004, our financial assistance programs have helped more than 1.3 million people to start or stay on life-changing treatment. In addition, we’ve achieved major policy victories that increase access to care, mobilized patient advocates to call for change, and educated people nationwide on critical healthcare-related topics. We’re committed to working towards a future where equitable health outcomes are a reality for all. To learn more, visit panfoundation.org.