Using nationally representative SHED 2022–2024 data, this study examines how unmet health needs, medical financial stress, and caregiving burdens shape insurance coverage and subjective financial well-being. Survey-weighted logistic models show that unmet needs are associated with higher odds of being uninsured, medical stress substantially lowers the probability of feeling better off than one year ago, and caregiving burdens markedly reduce the likelihood of reporting that the household is at least managing okay. Effects are graded and robust across specifications, amplified among low-income households and middle-aged and older adults, and partly buffered by dual coverage. Framed by Conservation of Resources theory, the results depict compounding loss spirals across access to care, liquidity, and time. The findings provide a pre-policy baseline relevant to current debates over Medicaid eligibility, caregiver supports, and medical-debt protections, and they offer concrete practice guidance on screening for clustered vulnerabilities that erode both structural security and perceived financial resilience.

Accepted Oral Presentation