Even with insurance, many Americans are forgoing a trip to thedoctor because of the out-of-pocket costs -- and many are fearingthey’re going to be priced out of the market altogether.

Related: Basic medical coverage is a bigdeal

According to a Bankratesurvey of 1,002 U.S. adults conducted by Princeton Survey ResearchAssociates, a quarter of respondents say they have decided not toseek medical attention when they’ve need it because of the cost.Older millennials, ages 27-36, were the most likely to say this (32percent).

“That’s surprising -- it was an answer even given by those whodo have health insurance,” says Robin Saks Frankel, credit cardanalyst at Bankrate.com.

More than half of Americans (56 percent) are worried they mightnot have affordable health insurance in the future. GenerationX, ages 37-52, are most concerned (64 percent), followed by babyboomers (58 percent), millennials (56 percent) and the silentgeneration (35 percent).

Frank says that’s roughly the same level of concern Bankrate.comfound when the firm’s surveyors asked the same question in August2013, two months before the opening of the health insuranceexchanges created under the Affordable Care Act.

Related: American families continue to see health care costsrise

Respondents to the May 2017 survey say they prefer the ACA tothe proposed American Health Care Act by a wide margin: 43 percentto 25 percent, while 12 percent say they prefer neither, and 19percent say they don’t know which plan to prefer.

“The future is pretty uncertain, but it’s highly likelyinsurance premiums across the board are going to increase, and itis likely deductibles will increase,” Frankel says.

Under the AHCA, the individual mandate will be eliminated, andif the legislation passes, she expects more people would choose notto have insurance.

But even if the ACA remains intact, people might still worryabout the unaffordability of health care insurance as premiumscontinue to rise, Frankel says. Anthem is pulling out of the Ohioexchange and 18 counties might not have any ACA plan, while Aetnaand Humana are pulling out of all the exchanges next year.

“If people can’t buy an insurance plan, they’re going to have toseek far more expensive options,” she says. “It’s all well and goodthat there may still be health care access, but if people can onlybuy expensive plans, they are practically useless.”

Related: 10 worst states for ACA premiums

As for future fixes to the ACA if the AHCA fails: “I hope that amore satisfactory option appears,” Frankel says. “It doesn’t seemlike any options out there now are going to be good for mostpeople.”

No matter what happens in Congress, Frankel recommends peoplehave an emergency fund to pay for medical treatments, “so theydon’t have to choose between financial health and physicalhealth.”

Health savings accounts are also an option, particularly if theybecome less complicated and more available to everyone, she says.Frankel also recommends maintaining continuous insurance coverage,as they may have to pay significantly higher premiums if theyre-enroll after letting policies lapse.