Ask who's to blame for your high medical bills and you get the pointing Spider-Man meme. Drug companies point at the insurers. Insurers point at the hospitals. Hospitals point at both of them. Everybody's wearing the same suit, and everybody swears it was the other guy.
Voters have their own take on which Spider-Man did it. In the healthcare polling I do, a quick favorability question makes drug companies and insurers look terrible and hospitals look great. When a spring OnMessage poll asked which part of the industry Congress should go after, 60% picked insurers, 18% drug companies and 8% hospitals.
Dig a little deeper and two things show up. First, the anger is mostly about what insurance costs. The Commonwealth Fund asked more than 25,000 adults to name the biggest problem in American healthcare, and more than 4 in 10 said the cost of insurance, Republicans and Democrats alike. Second, hospitals keep their good name only as long as people picture the doctors and nurses. Bring up the billing office and that changes fast. In a Texas poll from American Resolve and Cygnal, 60% of voters had gotten a hospital bill higher than they expected in the past year.
Insurance is about to get even more attention. ACA open enrollment opens a week from today, the second year without the extra subsidies Congress let lapse, and it closes December 15, a month earlier than it used to. Medicare enrollment is already underway, and Medicaid's new work requirements start in January.
Premiums, Not Pills
GrayHouse asked 2,000 likely voters in battleground states and districts whether Congress should focus on lowering the price of health insurance or the price of prescription drugs. Insurance won by 57 points. Asked for the one thing they'd want Congress to get done next year, 15% said lower insurance prices. 2% said lower drug prices.
Voters aren't against cheaper drugs. 87% back capping drug prices in a WSJ / NORC survey, and 85% of battleground voters 50 and older told AARP they'd favor a candidate who lets Medicare negotiate more drug prices. Drug pricing is popular. It just isn't urgent.
Employers see the same bill coming. Mercer projects that employer health costs will rise more than 8% per worker next year, the biggest jump since 2003, and about two-thirds of large employers told Marsh they plan to pass more of the premium on to their workers.
Year Two Without the Credits
The "enhanced credits" were the extra ACA subsidies Congress passed in 2021. They cut premiums for lower-income buyers, often to zero, and for the first time helped middle-class buyers by capping their premiums at 8.5% of income. They ran out at the end of 2025.
A year later, voters want them back. Cygnal, a Republican polling firm, surveyed the 25 most competitive House districts: 71% say their healthcare costs went up this year, 67% call letting the credits lapse a mistake, and 71% want them restored, including 70% of independents and half of Republicans.
It was a rough year for people who buy their own coverage. KFF estimated that subsidized enrollees who kept their plans would pay more than twice as much in 2026. Many traded down to bronze plans, the cheapest option with the highest deductibles; 40% picked one, up from about 30%. For 2027, insurers have asked for a median increase of another 15%.
People feel it. A survey of 2,732 voters for United States of Care, a nonpartisan health advocacy group, asked how satisfied people are with their coverage:
- Medicare: 66% satisfied
- VA: 60%
- Employer coverage: 42%
- ACA Marketplace: 40%
The government programs come out on top, and the Marketplace, where prices just jumped, comes in last.
Medicare for All Hits a High
With frustration this broad, it's no surprise that support for a big fix is growing. KFF finds 66% of adults favor Medicare for All, the highest since it started asking in 2017.
I'd read that 66% as a measure of frustration, not settled support for single payer, because it moves a lot depending on how you describe it. Tell people it would eliminate premiums and support climbs to about 75%. Tell them it could delay tests and treatment and it drops to about 25%. And 57% of people with private insurance think they'd get to keep their current plan, which most Medicare for All bills wouldn't allow.
The United States of Care survey found the same tension: 78% want the government to do more to make care affordable, but 52% want something short of an overhaul.
People want the government to do more about what they pay for care, and a slim majority want it done without starting over.
Smaller, specific fixes poll very well, even in Texas. A Texas 2036 poll found 90% of voters want the right to know who owns their hospitals, doctors' offices and insurers, and 79% want binding prices up front before non-emergency care. The least popular option tested was doing nothing: 61% against, 18% for.
Poll Vault tracked 63 healthcare polls since September 1. See them all →
The Paperwork Wall
Starting January 1, Trump's 2025 tax-and-spending law requires most working-age adults on expanded Medicaid to prove they work, study or volunteer 80 hours a month, or that they're exempt. Most of them know it's coming. Nearly half say they aren't ready.
Aeroflow Health surveyed 1,225 Medicaid enrollees this month. 63% know about the requirements, but 44% aren't prepared to document them and 46% haven't gotten a single reminder. Their top worry, at 33%, is simply knowing whether the rules apply to them. 53% say fear of losing coverage has already led them to put off or change their care.
This is a communications problem, and the enrollees told us how to fix it. 37% have missed an important health notice because it came by mail. Asked what would help, 53% said email reminders and 50% said texts. States and health plans have about two months to switch.
Under an Hour
Medicare enrollment runs through December 7, and most seniors barely look. In a University of Michigan / NORC poll taken after last year's enrollment period, 60% spent less than an hour choosing coverage, 27% spent no time at all, and 80% kept the plan they had. 92% still felt confident in their choices.
That confidence may outrun what they know. Only 38% had heard that Medicare's drug price negotiations lowered prices. And just 5% relied mainly on the free Medicare counselors every state offers. In an eHealth survey this month, 71% of beneficiaries called plan shopping confusing.
Quick Hits
🏥 In-network or else. 45% of Americans have been caught in a coverage or network fight between their insurer and a doctor or hospital in the past three years, SKDK / HarrisX found, and 30% of them delayed or canceled care because of it.
👩⚕️ Dismissed. 51% of women report a bad experience with a healthcare provider in the past five years, against 39% of men, per Gallup. The most common complaint: their symptoms or pain were brushed off.
💉 For vaccines, but not in line. 77% of adults call vaccines one of the best ways to prevent serious disease, but only 48% tried to get a flu, COVID, RSV or pneumonia shot last year, NFID / NORC found.
🩺 The doctor's still trusted. Confidence in people's own healthcare providers is holding at 87%, while confidence in the CDC, FDA and NIH has dropped about a dozen points since 2024, to around 60%, per Annenberg.
What Else We Tracked
- Most Americans Want Limits on Prescription Drug Ads, But a Ban Splits the Public Evenly — MedShadow Foundation / Siena
- Half of SSDI-Eligible Workers Don't Know They Have Disability Coverage — Atticus / SurveyMonkey
- Americans Who Quit GLP-1 Drugs Trust Pharma Less, Especially on Pricing — USC Schaeffer Center
- Gen Z and Millennial Trust in Health Insurers Drops More Than 10 Points Since 2023 — Accenture
- Half of Healthcare Workers Weigh Leaving; 70% of Gen Z Want Out — Harris Poll
- Nearly 4 in 10 Middle-Class Households Wrongly Expect Medicare to Cover Long-Term Care — American Council of Life Insurers
- Missouri Abortion Ban Hits Dead Heat as Voter Support Erodes Since February — Saint Louis University / YouGov
Until next time,
Alex Lundry
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