A new national survey from Imagine360, an alternative health plan for self-funded employers, finds one in three insured Americans say they are losing sleep over the cost of health care. The report notes that as employer-sponsored health care costs climb to record highs, 44 percent of survey respondents are skipping or delaying needed treatment, up from 38 percent in 2025. Nearly half of those individuals reported their medical conditions worsened as a result. Approximately 36 percent reported a household income at or below the U.S. median of $83,730, and 80 percent received health care coverage through an employer. The representative sample spans the United States: South (39 percent), Northeast (24 percent), Midwest (24 percent) and West (13 percent). Seventy-four percent of respondents say health plan benefits are a major factor when choosing or remaining with an employer, an increase from 66 percent in 2025.