Paying medical bills leads healthcare cost concerns

Among specific healthcare cost concerns, paying a medical bill leads all others, according to a new survey.

Healthcare costs, in general, are a long-standing and rising concern of patients and the public but less is known about which costs worry them most.

“We’ve asked about top issues in healthcare and this year seeing that cost was potentially a big concern,” Isaac Squyres, a senior partner at healthcare consulting firm Jarrard, said in an interview. “We wanted to go a bit deeper.”

A recent Jarrard survey of 1,049 adults identified what cost-related outcomes they were most worried about for 2026 and included:

• Having difficulty paying a medical bill — 59%
• Delaying care due to cost — 56%
• Lacking ability to afford health insurance — 55%
• Avoiding care due to cost — 55%
• Having care delayed by insurance — 55%

“When we think about the public’s concern about the cost of healthcare, generally, it moves across every dimension of the healthcare system in the country,” Squyres said. “And that leads to an overriding concern at a big-picture level, but each individual element is in itself noteworthy.”

Hospital views

Although health insurance companies and government drew most of the blame for cost increases, some also blamed hospitals. Additionally, 76% said hospitals are mostly focused on making money, while only 24% said hospitals were mostly focused on caring for patients.

The results followed a recent KFF analysis that hospitals accounted for a third of total health spending increases since 2023 but 40% of the total spending increase — higher than any other factor.

Squyres said that hospitals and health systems could benefit from communicating needed policy implications. Almost nine in 10 respondents indicated that they want to hear from doctors, nurses, hospitals and health systems, “around the important policy-related issues and talking about changes that have occurred that are impacting cost.”

Organizations need to have “a good message around how they are working to address affordability issues,” he said.

Several health systems recently detailed their latest efforts to address patient affordability.

Another detail from the survey was that the public’s cost concerns with hospitals were mitigated by perceptions of positive tradeoffs. That included having:

• 51% agree that it’s acceptable for a hospital, clinic or nursing home to try to make more money if they provide good care.
• 48% agree that it’s acceptable for those organizations to try to make more money if they contribute positively to the community.

The ability to tell the story of quality and positive impacts on a community are important aspects for organizations to consider as they think about their general messaging, said Squyres. “And how they are talking about their work on affordability which, of course, know that systems are working on all the time.”

2026 politics

The lead-up to the 2026 midterm elections likely will feature prominently healthcare and affordability issues, Squyres said. For instance, the latest KFF health tracking poll found that health care costs have overtaken all other household expenses as Americans’ top financial worry.

Healthcare providers can go on the offensive over potential impacts on healthcare costs from looming cuts to the growth of Medicaid and the end of COVID-19-era subsidies to ACA marketplaces. Physicians, nurses and provider organizations were the most trusted to explain the significance of healthcare policy changes.

Nuances in the policy arguments could come from how the public sees the loss of insurance by others affecting them. Most (57%) thought others losing insurance will increase their own costs but only 38% thought it would hurt their own access to healthcare.

Hospitals and health systems also should prepare a defense in their markets to counter national discussions of healthcare affordability and quality, he said.

Hospital and health system vulnerability to entanglement in broad healthcare affordability and quality discussions was illustrated in the survey. Fifty-six percent of respondents initially said they were confident their local hospitals will provide high-quality care in the coming years. But that share dropped to 43% after working through all the survey questions.

“It’s important for people to be active in the conversation with the right message to be talking about the important work that they’re doing around affordability, around quality, around community impact, around access,” he said. “Hospitals need to have the right approach in this very noisy year, given we believe that healthcare will be a big topic nationally.”

Other issues

The survey also indicated that hospitals’ relative popularity compared with insurance companies may give them a leg up with the public in the increasing number of high-profile contract disputes with payers.

“The element that is important is for organizations to have a clear story and to be communicating appropriately with their stakeholders about what the situation is,” Squyres said. “Engaging in the right way in those moments in time will be important.”

Additionally, the increasing adoption of AI by healthcare organizations drew a split reaction from the public. Thirty-eight percent see AI adoption in clinical settings as problematic, while 36% see it as positive.