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Americans are losing sleep over the cost of health care more than other money worries, according to a new national poll by CreditCards.com.

In a telephone survey of 1,000 U.S. adults, 38 percent said they toss and turn over health care and insurance bills – up from 29 percent in a similar survey done in 2016. Health care hasn’t been such a big source of insomnia since 2009 (35 percent), when newly inaugurated President Barack Obama rolled out his landmark health care reform bill. The recent debate in Washington about overhauling the health care system again likely exacerbated a financial worry that bugs consumers even in times of political calm.

“Health care costs are one of the three major drivers of delinquencies in consumer credit,” said James Chessen, chief economist at the American Bankers Association. “I think it’s always a concern. For individuals who are living paycheck to paycheck, that’s one cough or accident away from creating a financial problem.”

The survey also found that the percentage of consumers who lose sleep over their finances is trending toward levels not seen since the Great Recession. Sixty-five percent said they lie awake at night fretting over money worries, compared to 62 percent in both 2015 and 2016. Financial insomnia affected only 56 percent of people in 2007, but that number surged to 69 percent in 2009.



See poll infographic \xd7

Key poll findings

Here’s what our poll revealed about money worries that keep consumers up at night:

Health care tops all worries. Of the five times CreditCards.com has done this money worries poll since 2007, this is the first time health care has been the greatest producer of insomnia.

Of the five times CreditCards.com has done this money worries poll since 2007, this is the first time health care has been the greatest producer of insomnia. Saving for retirement still worrisome: Thirty-seven percent said they lie awake at night worrying about saving for retirement, down from 39 percent in 2016. Nearly half of Gen-Xers said they occasionally lose sleep over retirement savings.

Thirty-seven percent said they lie awake at night worrying about saving for retirement, down from 39 percent in 2016. Nearly half of Gen-Xers said they occasionally lose sleep over retirement savings. Student loans robs shut-eye. Many more Americans are losing sleep over their ability to pay educational expenses – from 30 percent in 2016 to 34 percent this year. Younger millennials (ages 18-26) are more sleep deprived over student loans than any other group.

Many more Americans are losing sleep over their ability to pay educational expenses – from 30 percent in 2016 to 34 percent this year. Younger millennials (ages 18-26) are more sleep deprived over student loans than any other group. Mortgage and rent woes stay constant: Worry over making the monthly mortgage or rent payment keeps about 1 in 4 Americans up at night, about the same percentage as every poll since 2009.

Worry over making the monthly mortgage or rent payment keeps about 1 in 4 Americans up at night, about the same percentage as every poll since 2009. Credit card debt? We mostly sleep through it. Paying off credit card debt (22 percent) keeps people up at night the least of any money worry. It has remained a relatively small concern since the Great Recession despite ballooning card balances and rising interest rates.

Paying off credit card debt (22 percent) keeps people up at night the least of any money worry. It has remained a relatively small concern since the Great Recession despite ballooning card balances and rising interest rates. Spending less is key to a good night’s sleep. For this year’s survey, we asked a new question: What are you doing about your worries? Of those losing sleep, nearly 2 in 3 (64 percent) said they reduced their expenses to improve their financial situation in the past 12 months.

The scientific poll of 1,000 consumers was conducted April 6-9 via landline and cellphone. See survey methodology.

Health care debate brings uncertainty

The Affordable Care Act has been the law of the land for seven years, but health care reform came storming back into the public debate in the first weeks of Donald Trump’s presidency. With control of the White House and both chambers of Congress, Republicans proposed new legislation that would fulfill Trump’s campaign promise to repeal and replace the act, commonly called Obamacare. The effort was abandoned in March by congressional Republicans, but not before it raised the prospect of millions losing health care.

Health care has been a partisan issue for quite some time, but uncertainty over potentially sweeping changes can cut across party lines. In our survey, more Democrats and independents (41 percent each) reported losing sleep over health care than Republicans (30 percent). But the cost of health care was still one of the biggest sleep deprivers among people of all party affiliations.

Maggie Baker, psychologist, financial therapist and author of the book “Crazy About Money: How Emotions Confuse our Money Choices and What to Do About It,” said the rancorous tone of the health care debate likely heightened consumers’ worries.

When you get sick you are very vulnerable, and you’re not thinking about how you’re going to pay bills. Emotionally, it wreaks havoc on the person who’s sick. \u2014 Maggie Baker

Psychologist and financial therapist

“Whether you’re a Republican or a Democrat, the amount of conflict we’ve been subjected to and the nasty disagreement has made people extremely anxious,” Baker said. “If we were in a calmer political situation in this country, I think people would be worried about health care, but the level of anxiety wouldn’t be quite as high.”

But even if we were all at ease with our health care system, the fear of a costly medical emergency would persist for many consumers.

“When you get sick you are very vulnerable, and you’re not thinking about how you’re going to pay these bills,” Baker said. “Then you have a $500,000 hospital bill and it’s one of the worst negative surprises you can ever get. Emotionally, it wreaks havoc on the person who’s sick.”

Retirement savings and other worries

For 37 percent of consumers, thinking about saving for retirement prepares you for sleep about as well as an espresso shot and a bucket of cold water in your face. But that number is 2 percent lower than it was in 2016, and this is the first time in our survey’s history that saving for retirement isn’t the biggest financial stressor.

However, people are growing increasingly concerned about paying off student loans. Thirty-four percent said they lose sleep over paying their educational expenses (or someone else’s), up from 30 percent in 2016 and 27 percent in 2009. It’s no surprise given the swelling debt load facing today’s college students and graduates. Outstanding student loan balances reached $1.4 trillion in December, according to the Federal Reserve.

Student loan debt worries will increasingly feed into retirement anxiety as the cost of education continues to rise.

“There are only so many dollars that can be saved in a person’s budget, and a lot of those are not going toward retirement,” said Martin Lynch, director of education at Cambridge Credit Counseling. “You wind up with a lot of people who are struggling to make ends meet in retirement.”

Only 22 percent of people surveyed said they miss out on the occasional good night’s rest because of credit card debt, and that has changed little since the Great Recession. It’s a sign that consumers feel they’re handling credit well, which is supported by recent delinquency statistics.

But a little more fretting might prevent a rude awakening. Card balances recently surpassed $1 trillion for the first time since 2009, and interest rates are rapidly rising.

“I’ll bet if you made a graph of the amount of interest that somebody was paying for that debt, and you put it in front of them, they wouldn’t sleep well that night,” Baker said. “We as a country are going to get in trouble if [interest rates] go up too fast.”

Trimming expenses: The sleep remedy of choice

Not content feeling like financially stressed zombies from time to time, 82 percent of consumers reported taking at least one step to improve their money situation. The majority (55 percent) simply cut back on expenses. Twenty-one percent sold something they owned to raise money, 14 percent got a new credit card and 13 percent took out a loan. Another 12 percent got a second job.

It’s only natural that most cash-strapped consumers would rather spend less money than take on new debt or work more hours. But Lynch of Cambridge Credit Counseling advocates the latter option as a secondary plan, even though it could take time to find a second job. (Not to mention that working more probably won’t help you get more sleep.)

The economy is strong – time for a nap?

It’s concerning that consumers don’t feel much better about their finances than they did during the Great Recession, despite low unemployment and steady wage growth. But we will likely always experience some level of financial anxiety, even if lawmakers call a truce on health care and find a way to bring student loan debt under control. And the U.S. economy may be long overdue for another downturn, if not a return to the depths of the recession.

“It’s now eight years into the economic expansion,” said the banking association’s Chessen. “There was some nervousness in the middle of last year that the economy was starting to slow. There’s always a worry that people have about money, and I think it’s heightened when there’s great uncertainty.”

Survey methodology

CreditCards.com commissioned Princeton Survey Research Associates International to obtain telephone interviews with 1,000 adults living in the continental United States. Interviews were conducted by landline and cellphone in English and Spanish from April 6-9, 2017. Statistical results are weighted to correct known demographic discrepancies. The margin of sampling error is plus or minus 3.8 percentage points for the full sample, and plus or minus4.9 percentage points for the subset of 587 people who said they lost sleep over finances.

See related: 5 reasons not to put medical bills on credit cards, Consumer debts rise, but fears of missing payments fall