Top Things to Know: American Heart Association Presidential Advisory on Health Care Affordability

Updated: April 30, 2026

This advisory builds on AHA’s longstanding policy foundation.
In 2020, the Association published Principles for Adequate, Accessible and Affordable Healthcare. This Presidential Advisory builds on that work by defining core principles that should guide future solutions to the health care affordability crisis.
US health care spending is unsustainably high and rising.
Health care spending reached $5.3 trillion in 2024 and is projected to consume over 20% of the GDP by 2033, outpacing economic growth.
Chronic diseases, especially cardiovascular disease, are major health spending drivers.
Cardiovascular disease and other chronic conditions are projected to be a major driver of future cost growth, with CVD-related health care costs expected to nearly quadruple by 2050.
Affordability is both a system-level and patient-level crisis.
Rising total spending threatens health system sustainability; simultaneously, patients are struggling to afford rising out-of-pocket costs, leading to delayed care and financial toxicity.
The drivers of the health care affordability crisis are broad and interconnected.
Key drivers include high prices for treatments and services, utilization patterns, administrative complexity, underinvestment in prevention and public health, demographic shifts, social inequities, and cost shifting to patients.
The consequences of the health care affordability crisis affect stakeholders across the health care ecosystem.
Rising costs, coverage gaps, administrative hurdles, and medical debt impact patients and families while also placing significant strain on clinicians, employers, health systems, and communities.
The crisis disproportionately affects vulnerable communities.
Affordability challenges often hit low-income, rural, and historically marginalized populations hardest, exacerbating existing structural inequities in access to care.
Affordability is not just about cutting costs, it requires smart investments.
Sustainable solutions must pair cost containment with strategic investments in workforce, infrastructure, primary care, and public health.
The advisory reflects broad stakeholder perspectives.
AHA convened patients, payers, clinicians, employers, health system leaders, and public health professionals to understand how affordability is defined and experienced across stakeholders.
The Association proposes five principles to ensure affordable care while supporting long-term system sustainability.

View the summary for Health Care Affordability in the United States, From Crisis to Action

Citation

Kazi DS, Beckman JA, Benjamin RM, Firestone G, Johnson JC, McClellan MB, Meltzer N, Oxrider A, Rosen SE, Scott BL, Volpp KG, Warner JJ; on behalf of the American Heart Association. Health care affordability in the United States: from crisis to action: a presidential advisory from the American Heart Association. Circulation. Published online April 30, 2026. doi: 10.1161/CIR.0000000000001442