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WASHINGTON, D.C. -- Fifty-five percent of Americans worry "a great deal" about the availability and affordability of healthcare, topping Â鶹´«Ã½AV's list of potentially worrisome issues for the fifth straight year. A majority of Americans have said they worry a great deal about healthcare in each of the 18 years the question has been asked since 2001, more than twice as often as any of the other 12 issues most often measured.

	Great deal	Fair amount	Only a little/Not at all
	%	%	%
The availability and affordability of healthcare	55	25	21
Federal spending and the budget deficit	50	30	20
Hunger and homelessness	49	30	20
Drug use	47	26	27
Crime and violence	47	28	25
The quality of the environment	47	27	26
The way income and wealth are distributed in the U.S.	44	23	33
The availability of guns	41	20	39
The Social Security system	41	26	33
Race relations	40	26	34
Illegal immigration	36	18	45
The possibility of future terrorist attacks in the U.S.	33	27	40
The economy	33	34	33
The availability and affordability of energy	28	29	43
Unemployment	23	28	49
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The consistency of concern about healthcare stands in contrast to the other economic issues that dominated Â鶹´«Ã½AV's list of worries in 2010 and 2011, as the nation began its climb out of the 2008-2009 Great Recession.

The percentage of Americans who worried a great deal about the economy reached its highest point, 71%, in 2011 and 2012, but this has plummeted to 33% in 2019. The percentages worrying a great deal about the Social Security system or federal spending and the budget deficit have declined more gradually since their 2010-2011 peaks, but both have fallen more than 10 percentage points -- though worries about spending and the deficit are still high.

Meanwhile, the percentage worrying a great deal about the availability and affordability of healthcare has held steady. It is within one point of where it was in 2010 (56%) and has never dropped below 54% over the past nine years. In October, Americans said healthcare was one of their top issues for the midterm elections, and in November, 61% said the possibility of increases in healthcare insurance costs was "a major concern."

The persistence of Americans' concern about healthcare has not escaped the attention of politicians. The issue has been at the forefront of national politics over the past two decades -- even after Democrats, led by President Barack Obama, passed the landmark Affordable Care Act in 2010. Republican lawmakers have made numerous unsuccessful attempts to repeal it -- and at least one successful attempt to modify it -- in the years since it took effect.

The political fight has intensified in recent weeks, with new initiatives from both parties:

• More than 100 Democrats backed a new "Medicare for All" bill introduced in the House of Representatives Feb. 27. The bill, pushed by the progressive wing of the party, would create a single-payer, government-funded healthcare program within two years.
• President Donald Trump last week renewed his attempt to overthrow the ACA through the administration's Justice Department. A letter from the department filed last Monday says it backs a federal judge's ruling in December that the Affordable Care Act violated the U.S. Constitution because it required people to buy health insurance.
• House Speaker Nancy Pelosi unveiled the Democrats' new healthcare plan last Tuesday. Its major goals include lowering health insurance premiums, strengthening protections for Americans with pre-existing medical conditions and instituting a ban on what Democrats term "junk insurance" -- insurance policies that would not be required to cover maternity care, prescription drugs or those with pre-existing conditions.

Worries Increase About Homelessness, Decrease About Terrorism, Guns

Several issues measured in the March 1-10 poll set new landmarks in the 19-year history of the question for highs or lows in the level of worry, though most were not significant changes from the previous records:

• Forty-nine percent now worry a great deal about hunger and homelessness, two points above the previous high measured in 2016 and 2017, and five points higher than last year's 44%. The level of worry has been on a gradual upward climb since 2008, when 38% said they worried about it a great deal.
• Thirty-three percent worry a great deal about the possibility of future terrorist attacks in the U.S. -- seven points lower than last year and a single point below the previous low from 2013.
• The percentage worrying a great deal about the availability of guns (41%) dropped 10 points from last year, the only other time it has been included in the list. Last year's poll was conducted only a few weeks after the mass shooting tragedy at a high school in Parkland, Florida.
• The percentage of Americans saying they worry about the economy (33%) dropped one point below last year's reading, the previous low.
• The 41% worrying a great deal about the Social Security system is three points below last year's low.

On three other issues, the percentage of Americans who worry a great deal has grown significantly in the past five years.

• Thirty-one percent worried a great deal about the quality of the environment in 2014, the low reading in the trend. That number has grown to 47%.
• Thirty-four percent worried a great deal about drug use in 2014, also the trend low, but 47% do now.
• Seventeen percent worried a great deal in 2014 about race relations; now 40% do.

Bottom Line

Over the past 19 years, majorities have on multiple occasions expressed a great deal of worry about such key economic issues as the overall economy, unemployment, the Social Security system, federal spending or the budget deficit. A few other issues -- drug use, terrorism, guns -- have seen a majority express a great deal of concern a single time. But none of these issues have come close to producing the consistently high levels of worry Americans have shown about their healthcare.

Attempts by both Democrats and Republicans to create a trustworthy healthcare system have so far failed to quell Americans' concerns -- even when the political efforts produced groundbreaking legislation. Those concerns are unlikely to abate until changes are made that produce results that most Americans clearly and concretely feel in their daily dealings with the issue.

View complete question responses and trends.

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