The one who does the worrying

One · What happened

The share who can afford care fell, and it didn’t fall evenly

Gallup and West Health ask US adults the same question every year, whether they can get the care and the medicine they need, when they need it, without any of it wrecking them financially. Whoever can say yes without hedging gets counted Cost Secure. In 2025 that was 49% of adults, the lowest share since Gallup started the index in 2021. 41% land in Cost Insecure. 10% are Cost Desperate. They lack reliable access to care and have recently gone without it as well.

Split the same number by sex, and the picture changes. 57% of men are Cost Secure. 42% of women are. That’s a 15-point gap, the widest Gallup has measured since 2021, when the average gap ran closer to 9 points a year. Women’s own number dropped from 48% to 42% in the space of one year. Men’s rose 2 points over that same stretch.

Worry about affording care later has moved the same direction. 51% of adults now say they’re worried about being able to pay for care in the future, up from 42% when Gallup first asked in 2021.

Two · What it is doing

The tracking becomes one person’s job, and nobody assigned it

In most houses somebody ends up holding all of this in their head, when the insurance renews, what this year’s deductible actually is, whether the follow-up call ever got made, whether the check-up got booked before the school year swallowed the calendar. Nobody sits down and assigns that job. It settles on one person, usually early in the marriage, and stays there for years without either of you noticing it happened.

She’s the one who calls the billing office back a third time because the first two calls went nowhere. He tells her everything’s fine, and mostly believes it, while she’s still awake doing the math on what the bill will actually cost once the claim comes back different from the estimate the front desk gave over the phone. Neither one of them is lying to the other, not exactly. They’re just holding two different sizes of the same fear, and only one of them knows exactly how big it’s gotten.

Gallup’s own researchers name who took the harder hit these last few years, women, worn down more than men by pandemic-era income shifts and by health prices that outran the rest of the budget. That’s a national number. It can’t tell you whether the person doing this work in your particular house has ever told you the real dollar figure, the one that isn’t in the estimate.

Three · Where the ground is

Two people were meant to carry this, not one

Ecclesiastes 4 names this weight exactly. “Two are better than one, because they have a good reward for their toil. For if they fall, one will lift up his fellow. But woe to him who is alone when he falls and has not another to lift him up!” (Ecclesiastes 4:9-10). The writer isn’t talking about a health plan. He’s talking about the basic math of carrying anything heavy, and this year the heavy thing just happens to be a deductible, not a harvest.

Some of this is a decision. Made quietly, usually with good intentions, but still a decision. She doesn’t want to worry him, and she doesn’t want to sound like she’s failing at something either. She wants the family to look like it has this handled, even on the nights it doesn’t. Scripture doesn’t call that virtue. Galatians 6:2 tells believers to “bear one another’s burdens, and so fulfill the law of Christ.” A husband can’t carry a weight he was never told about. A wife who keeps the real number from him isn’t protecting the marriage. She’s avoiding a hard conversation, and the avoidance has its own cost.

Peter wrote to scattered, frightened believers and told them to keep “casting all your care upon him; for he careth for you” (1 Peter 5:7). That’s not a promise the number comes down or the claim gets approved the way you hoped. Peter wrote it to a whole church, plural, and he assumed they’d be doing this for each other, not each of them going to God with a fear the other one had never heard.

If this has been the shape of your house for years, one of you carrying it and the other not fully aware of how heavy it’s gotten, and neither of you can find your way to sharing it evenly no matter how many times you’ve tried, that isn’t a failure of the marriage. That’s what a pastor or a biblical counselor is for. Asking for that help isn’t a sign you’ve failed each other.

Four · Today

Five things, and none of them are “stay informed”

This doesn’t get better just because you decide to worry less. What changes this week is where the weight actually sits, and how much of it the other person in the house has ever been allowed to see.

1. 01

   Ask the specific question tonight.

   Not “how are we doing” or “are you okay.” Ask what the one health or money thing is that the other person has been carrying without telling you. Use those close to exact words, then wait for an actual number, not vague reassurance.

2. 02

   Take over one recurring task this week.

   The renewal call, the follow-up nobody’s made yet, the appointment that needs booking before the month fills up. Pick whichever one currently exists only in the other person’s memory, and do it yourself before they have to ask.

3. 03

   Put the dates where both of you can see them.

   The renewal date, this year’s deductible, the appointment you keep meaning to book. One shared note, a calendar on the fridge, anything besides a fact that only lives in one person’s head.

4. 04

   Tell one other person the real number.

   Not “we’re stressed about money,” the actual dollar figure or the actual fear behind it, said to a specific person outside your house this week. A number is something somebody else can actually pray about. A feeling mostly just sits there.

5. 05

   Pray about the named thing together.

   Once you’ve each said the actual worry to the other, take a few minutes before the light goes off and bring that specific thing to God in the same room, together, both of you, so neither one of you is handing it to Him alone from your own side of the bed.