Key findings:

  • Sentiment toward U.S. health insurers has declined across generations over the past year
  • Millennials and Gen Z show the sharpest drops in both Impression and Value metrics
  • Price and premiums remain the top considerations when Americans choose health insurance
  • Upcoming premium hikes in 2026 could further challenge perceptions of value

In an earlier YouGov story, we explored how Americans of different generations view healthcare and pharma in the US, finding that younger adults, particularly Gen Z and Millennials, tend to be more skeptical of drug manufacturers than their older counterparts.

In this follow-up, we turn our attention to another key player in the U.S. healthcare ecosystem: health insurers. Using BrandIndex data, we examine how generational attitudes toward major health insurance carriers have shifted over the past year, not only in terms of overall impression, but also perceived value for money.

According to YouGov BrandIndex, which tracks public perception daily across a range of brand metrics, both Impression and Value scores among Gen Z and Millennials have slipped steadily over the past year. 

Younger generations drive a downturn in overall impression of health insurers

Over the past year, among all Americans, Impression score of health insurers has slipped from a net score of 9 to 5. Here, the Impression metric measures whether people have a positive or negative impression of health insurers in the U.S. 

Among Gen Z and Millennials, sentiment toward health insurers has fallen far more sharply than among older generations. In October 2024, Millennials led all groups with an Impression score of around 11, while Gen Z stood close behind at 9. Both cohorts saw their views deteriorate rapidly through early 2025, by March, Millennials’ score had slipped to just 4, and Gen Z to 6. As of October 2025, Impression scores for both Millennials and Gen Z are at 1.

Among Baby Boomers and Gen X, Impression scores followed a downward path over the past year. In October 2024, Boomers held a score of 9 and Gen X stood at 7. As of October 2025, their scores are 6 for Boomers and 2 for Gen X.

Among the Silent and pre-Silent generation, the Impression score has edged down from 10 in October 2024 to 8 as of October 2025, indicating overall stability despite fluctuations.

Price, premiums, and out-of-pocket costs drive health insurance choices

When Americans shop for health insurance, cost leads every other consideration. More than half of U.S. adults (57%) say price and premiums are their top priority, closely followed by prescription drug coverage (54%), deductibles (47%), and copayments or coinsurance (45%). Practical elements such as provider networks (45%) and coverage options (43%) sit in a similar range. 

The focus on affordability extends further: 42% mention the out-of-pocket maximum, and 35% cite coverage limits and exclusions, both tied to how much consumers ultimately pay. Fewer prioritize preventive care and wellness programs (33%) or telehealth services (15%).

With cost playing such a critical role in health insurance purchase behaviours, it makes perceptions of value for money central to how people judge insurers — and on that measure, younger generations are the hardest to convince.

Value: Younger Americans question whether insurance is worth the cost

Across the general American population and all generations, perceptions of whether health insurers offer good value for money have declined over the past year. In October 2024, Millennials rated insurers highest on Value at 8, followed by Gen Z at 7, Gen X near 1, Baby Boomers at 2, and the Silent and Pre-Silent generation at 3. Among the general American population, the score was 4.

A year later, in October 2025, all five groups record lower scores. Gen Z has slipped to 1, Millennials to –2, Gen X to –4, and Baby Boomers to roughly 0. The declines cut across age and experience, but the sharpest drops come from younger adults, especially Millennials, who now view health insurance as a poor deal for the price.

Sentiment toward health insurers is softening across generations, and younger Americans are now particularly skeptical that coverage is worth the cost. With price as the dominant concern in purchase decisions, eroding perceptions of value may be the next front in insurers’ trust challenge.

But how to health insurers fare when compared to another section of the health and pharma space? It doesn’t look very promising. For example, when compared with drug manufacturers on Impression and Value, health insurers lose out.

In October 2024, Impression for drug manufacturers was a net score of 11 and Value score for the sector stood at 4. When we look at health insurers as a sector at the same time, Impression for it was 9 and Value was 4. While the scores for drug manufacturers hasn’t changed much, that is not the case for health insurers. 

For this sector, Impression has dropped to a net score of 5 and Value finds itself at –0.2.

With announced or proposed premium increases for both ACA marketplace and employer plans expected in early 2026, these perceptions may harden. Insurers will have to do more than sound compelling on features and networks; they’ll need to prove that their plans deliver real value, especially to a generation already signaling that they’re not convinced.

Methodology:

YouGov BrandIndex collects data on thousands of brands every day.

Impression score is based on the question: Overall, of which of the following insurance carriers do you have a positive impression of?. Scores are reported as net scores from –100 to +100, based on daily surveys of US adults. Data is weighted using a propensity scoring methodology with targets from the American Community Survey (ACS) to ensure representation by age, gender, race, education, and region. Figures are shown as a 12-week moving average with sample size ranging from 1,818 to 48,307 (varies by generation and date) between October 16, 2024 to October 15, 2025. 

YouGov BrandIndex collects data on thousands of brands every day. Value score is based on the question: Which of the following insurance carriers do you think represents good value for money?. Scores are reported as net scores from –100 to +100, based on daily surveys of US adults. Data is weighted using a propensity scoring methodology with targets from the American Community Survey (ACS) to ensure representation by age, gender, race, education, and region. Figures are shown as a 12-week moving average with sample size ranging from 1,818 to 48,307 (varies by generation and date) between October 16, 2024 to October 15, 2025. 

YouGov Profiles is based on continuously collected data through rolling surveys, rather than a single limited questionnaire. Figures are drawn from responses collected between 11 October 2024 and 12 October 2025, using a 52-week dataset updated weekly. Data is nationally representative of adults (18+) in the US and weighted by age, gender, education, region, and race.

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