For the past year, The Century Foundation has documented how American families are falling further and further behind financially—from skipped meals and drained savings accounts, to mounting balances on utility bills, student loans, credit cards, and auto loans. Our new polling confirms why for many, healthcare has become the leading edge of the cost-of-living crisis, the clearest issue where voters’ patience with the status quo has run out.
To understand how people are experiencing the healthcare system today, TCF commissioned Morning Consult to survey 2,002 registered voters nationwide May 21–24, 2026. The findings point to three conclusions.
- First, healthcare costs are imposing a heavy and broadly shared burden, forcing millions of families—including Americans with “good” job-based insurance—to ration care, take on debt, and switch to worse coverage.
- Second, voters think President Trump has made healthcare in America worse—and they want major reforms to the healthcare system going forward. Only 22 percent think Trump has improved healthcare, while two-thirds of voters want either new public coverage options or a complete overhaul of the healthcare system.
- Third, when voters were asked what leaders should do specifically, stopping hospitals from overcharging patients was at the top of the list, along with bans on surprise billing and caps on insurance company profits.
Taken together, our findings offer an important lesson for policymakers: defending Medicaid and the Affordable Care Act (ACA) against Trump’s cuts is necessary but not sufficient. Voters are demanding that their leaders make major changes to the current system.
The Backdrop: What Rising Healthcare Costs Are Doing to Families
Millions are rationing care, taking on debt, or downgrading their health coverage
We asked people whether they had taken any of a series of actions in the past year “directly due to the cost of healthcare or medicine” and the results show that millions of Americans are quietly triaging their own medical care. More than half of voters (53 percent) report cutting back on care or taking on debt to cope with healthcare costs—whether delaying care, switching to cheaper alternatives, dropping coverage, or taking on credit or medical debt. More than one in five (22 percent) delayed or avoided going to the doctor, while one in six (17 percent) took on credit card or medical debt to cover health costs.
Figure 1
These results provide context to other surveys over the past year that show healthcare costs at or near the top of Americans’ financial worries—often ahead of food, housing, and utilities. Healthcare affordability now ranks as the public’s single greatest national concern in Gallup’s issue tracking, even above the economy and inflation, and a growing number of candidates for office are centering voters’ healthcare concerns on the campaign trail.
The growing cracks in “good” employer coverage
Recent public attention has rightly focused on the populations bearing the brunt of the Trump administration’s healthcare changes: namely, Medicaid enrollees facing nearly $1 trillion in cuts and stringent new work requirements, as well as ACA marketplace enrollees absorbing unprecedented premium spikes after the expiration of enhanced subsidies. But our survey reveals that rising cost burdens also extend to what has long been considered the safe harbor of American health coverage: employer-sponsored insurance, which covers roughly 165 million people, by far the largest source of health coverage for working-age adults.
Among voters with employer-based insurance, nearly three-quarters (74 percent) report at least one form of cost increase, coverage deterioration, or other difficulty with their insurance in the past two years. This includes 36 percent who said their premiums increased, 31 percent who saw co-pays for doctor’s visits or prescription drugs rise, and 27 percent who said their deductible or out-of-pocket maximum increased.
Figure 2
Americans Want Major Healthcare Reform, Not Modest Fixes
Reversing Trump’s changes is not enough
We asked voters how they wanted their elected officials to respond to the healthcare changes made by President Trump, presenting them with three different options. Only one in five people (22 percent) said Trump’s changes “have improved health care and should be kept,” including only two in five Republicans (42 percent) who defend Trump’s healthcare record. Another 23 percent of voters said “we should reverse the Trump administration’s changes and return to the healthcare system we had before,” while a 38 percent plurality said “reversing the Trump administration’s changes is not enough—we need to go further and fix the deeper problems with American healthcare.”
This “not enough/go further” plurality holds across nearly every demographic line and includes 47 percent of Democrats (compared to 36 percent who favor reversal), 40 percent of moderates (compared to 28 percent for reversal), and 39 percent of suburban voters (compared to 25 percent for reversal). Independents favor going further over restoration by a 17-point margin (38 percent compared to 21 percent), while only 13 percent of independents defend Trump’s healthcare changes. Among women, 38 percent say reversal is not enough compared to 23 percent who want to return to the pre-Trump system.
Figure 3
These results signal that voters don’t want to be reassured that things will go back to normal; they want to know their leaders have a plan to fix what was already broken. While ongoing fights to restore the ACA’s enhanced tax credits and reverse Medicaid cuts are urgent and popular on their own terms, defending against Trump’s cuts should be considered the floor. The ceiling—what voters really want—are leaders who pair that defense with a credible and aggressive vision to tackle the deeper problems within American healthcare.
Two-thirds of voters want new public insurance options or a complete overhaul of the system
We asked voters about their preferred long-term direction for American healthcare and the answer was clear: people want significant reform or a total overhaul of the system. Only one in four voters (27 percent) said the current system is “basically working” but needs greater accountability to lower costs. By contrast, 30 percent said the system “needs new government options alongside private insurance,” while 36 percent went further still, saying the system is “broken and needs a complete overhaul.” Combined, two in three Americans (66 percent) want either major new public options, such as expanding Medicare, or wholesale structural change.
Figure 4
This desire for transformation is widely shared. “Complete overhaul” is the plurality position among Democrats (42 percent) and independents (38 percent) alike, and even among Republicans, a combined 56 percent favor either new government options or a redesign of the system over more modest reforms (37 percent). Majorities of every age cohort under 65 also prefer new public options or structural redesign by wide margins.
Moreover, a public option is now supported by nearly eight in ten Americans (78 percent) who think it should be a federal government priority, including 72 percent of Republicans and 75 percent of independents. A majority of all voters (51 percent) think it should be a top priority for the federal government, including more than six in ten Democrats (62 percent). This breadth of support suggests that the public option has shifted from contested ideological ground to mainstream common sense.
Cracking Down on Hospital Price-Gouging Garnered the Most Support
Policies that target a specific consumer ripoff earn the highest levels of voter support
We presented voters with seven concrete federal actions to lower health care costs, spanning a range of prominent ideas in the current policy debate—from aggressive market regulation to guaranteeing free primary care—and asked how much of a priority each should be. Every policy we tested generated overwhelming support, with at least 74 percent of voters calling each one a priority. The American electorate, in other words, is not conflicted about whether Washington should act on healthcare costs.
But within that consensus, a clear hierarchy emerged: the policies that performed best focused on protecting people from being ripped off. The top two performers—stopping hospital price-gouging and banning surprise billing—dominated the field both on breadth (the share calling them a priority at all) and intensity of support (the share calling them a top priority).
Figure 5
Hospitals shouldn’t be a third rail of healthcare reform—they should be a core focus
The findings on stopping hospital overcharging deserve particular attention. Two in three Americans (67 percent) believe stopping hospitals from charging excessive prices should be a top priority for the federal government, a full seven points and fourteen points higher, respectively, than the second- and third-best-performing ideas we tested (banning surprise billing and capping insurance profits). Support is also deeply cross-partisan: 71 percent of Democrats think it should be a top priority, as do 66 percent of Republicans and 62 percent of independents. Three in four rural voters (75 percent) think it should be a top priority, as do 70 percent of women, 73 percent of Republican women, and 77 percent of Baby Boomers.
While politicians in both parties tend to target pharmaceutical companies and insurers as the primary villains behind rising healthcare costs, leaders are much more willing to give hospitals a pass. This is a mistake—both in terms of where voters are at as well as fully capturing who is actually responsible for spiraling healthcare costs. As The Century Foundation’s Jeanne Lambrew details in a new piece, hospital prices are the leading driver of rising healthcare costs in recent years: from 2006 to 2023, hospital prices grew twice as fast as prescription drugs and insurance prices. At the same time, lobbying spending by hospitals has risen sharply, now ranking sixth highest by industry, and there has been a rapid increase in hospital concentration, which has contributed to the decline of key services in many parts of the country, such as maternity care in rural areas.
Conclusion
These results do not exist in a vacuum. They reflect a decade-plus of consolidation in American healthcare that has transformed it into one of the most concentrated corporate sectors in the economy. Hospital systems have merged into regional monopolies, private equity firms have bought up emergency rooms and physician practices, and the largest insurers have vertically integrated such that the same conglomerate often employs the doctor, approves (or rejects) recommended treatments, and pockets the difference. Prior authorization denials, surprise bills, and opaque pricing are not glitches in the American healthcare system—they are the predominant business model.
Our survey shows that the American public has reached its own verdict on that model. Two-thirds of voters want major change, including new public insurance options or a complete overhaul of the system, and a plurality says that simply reversing the Trump administration’s changes does not go far enough. Americans across every partisan and demographic line want the federal government to take aggressive action to end corporate abuses in healthcare, with stopping hospital price-gouging at the top of the list. Voters want leaders to offer a credible plan that doesn’t merely tinker around the edges, but aggressively challenges the deeply broken status quo.
Methodology
The poll was conducted by Morning Consult from May 21 to May 24, 2026 among a sample of 2,002 registered voters in the United States. The interviews were conducted online and the data were weighted to approximate a target sample of registered voters based on gender, race, age, children in household, educational attainment, marital status, home ownership, region, and 2024 presidential vote.
Results from the full survey have a margin of error of plus or minus 2 percentage points; margins of error for subgroups are larger. Questions about employer-sponsored insurance were asked of the 630 respondents who receive coverage through their or a family member’s employer. Data characterizing the share of respondents taking “at least one” action were calculated as the complement of respondents selecting “none of the above” on the relevant select-all-that-apply battery. Full toplines and crosstabs are available upon request.
Tags: polling
As Healthcare Costs Spiral, a Supermajority of Americans Want Major Reform
For the past year, The Century Foundation has documented how American families are falling further and further behind financially—from skipped meals and drained savings accounts, to mounting balances on utility bills, student loans, credit cards, and auto loans. Our new polling confirms why for many, healthcare has become the leading edge of the cost-of-living crisis, the clearest issue where voters’ patience with the status quo has run out.
To understand how people are experiencing the healthcare system today, TCF commissioned Morning Consult to survey 2,002 registered voters nationwide May 21–24, 2026.1 The findings point to three conclusions.
Taken together, our findings offer an important lesson for policymakers: defending Medicaid and the Affordable Care Act (ACA) against Trump’s cuts is necessary but not sufficient. Voters are demanding that their leaders make major changes to the current system.
The Backdrop: What Rising Healthcare Costs Are Doing to Families
Millions are rationing care, taking on debt, or downgrading their health coverage
We asked people whether they had taken any of a series of actions in the past year “directly due to the cost of healthcare or medicine” and the results show that millions of Americans are quietly triaging their own medical care. More than half of voters (53 percent) report cutting back on care or taking on debt to cope with healthcare costs—whether delaying care, switching to cheaper alternatives, dropping coverage, or taking on credit or medical debt. More than one in five (22 percent) delayed or avoided going to the doctor, while one in six (17 percent) took on credit card or medical debt to cover health costs.
Figure 1
These results provide context to other surveys over the past year that show healthcare costs at or near the top of Americans’ financial worries—often ahead of food, housing, and utilities. Healthcare affordability now ranks as the public’s single greatest national concern in Gallup’s issue tracking, even above the economy and inflation, and a growing number of candidates for office are centering voters’ healthcare concerns on the campaign trail.
The growing cracks in “good” employer coverage
Recent public attention has rightly focused on the populations bearing the brunt of the Trump administration’s healthcare changes: namely, Medicaid enrollees facing nearly $1 trillion in cuts and stringent new work requirements, as well as ACA marketplace enrollees absorbing unprecedented premium spikes after the expiration of enhanced subsidies. But our survey reveals that rising cost burdens also extend to what has long been considered the safe harbor of American health coverage: employer-sponsored insurance, which covers roughly 165 million people, by far the largest source of health coverage for working-age adults.
Among voters with employer-based insurance, nearly three-quarters (74 percent) report at least one form of cost increase, coverage deterioration, or other difficulty with their insurance in the past two years. This includes 36 percent who said their premiums increased, 31 percent who saw co-pays for doctor’s visits or prescription drugs rise, and 27 percent who said their deductible or out-of-pocket maximum increased.
Figure 2
Americans Want Major Healthcare Reform, Not Modest Fixes
Reversing Trump’s changes is not enough
We asked voters how they wanted their elected officials to respond to the healthcare changes made by President Trump, presenting them with three different options. Only one in five people (22 percent) said Trump’s changes “have improved health care and should be kept,” including only two in five Republicans (42 percent) who defend Trump’s healthcare record. Another 23 percent of voters said “we should reverse the Trump administration’s changes and return to the healthcare system we had before,” while a 38 percent plurality said “reversing the Trump administration’s changes is not enough—we need to go further and fix the deeper problems with American healthcare.”
This “not enough/go further” plurality holds across nearly every demographic line and includes 47 percent of Democrats (compared to 36 percent who favor reversal), 40 percent of moderates (compared to 28 percent for reversal), and 39 percent of suburban voters (compared to 25 percent for reversal). Independents favor going further over restoration by a 17-point margin (38 percent compared to 21 percent), while only 13 percent of independents defend Trump’s healthcare changes. Among women, 38 percent say reversal is not enough compared to 23 percent who want to return to the pre-Trump system.
Figure 3
These results signal that voters don’t want to be reassured that things will go back to normal; they want to know their leaders have a plan to fix what was already broken. While ongoing fights to restore the ACA’s enhanced tax credits and reverse Medicaid cuts are urgent and popular on their own terms, defending against Trump’s cuts should be considered the floor. The ceiling—what voters really want—are leaders who pair that defense with a credible and aggressive vision to tackle the deeper problems within American healthcare.
Two-thirds of voters want new public insurance options or a complete overhaul of the system
We asked voters about their preferred long-term direction for American healthcare and the answer was clear: people want significant reform or a total overhaul of the system. Only one in four voters (27 percent) said the current system is “basically working” but needs greater accountability to lower costs. By contrast, 30 percent said the system “needs new government options alongside private insurance,” while 36 percent went further still, saying the system is “broken and needs a complete overhaul.” Combined, two in three Americans (66 percent) want either major new public options, such as expanding Medicare, or wholesale structural change.
Figure 4
This desire for transformation is widely shared. “Complete overhaul” is the plurality position among Democrats (42 percent) and independents (38 percent) alike, and even among Republicans, a combined 56 percent favor either new government options or a redesign of the system over more modest reforms (37 percent). Majorities of every age cohort under 65 also prefer new public options or structural redesign by wide margins.
Moreover, a public option is now supported by nearly eight in ten Americans (78 percent) who think it should be a federal government priority, including 72 percent of Republicans and 75 percent of independents. A majority of all voters (51 percent) think it should be a top priority for the federal government, including more than six in ten Democrats (62 percent). This breadth of support suggests that the public option has shifted from contested ideological ground to mainstream common sense.
Cracking Down on Hospital Price-Gouging Garnered the Most Support
Policies that target a specific consumer ripoff earn the highest levels of voter support
We presented voters with seven concrete federal actions to lower health care costs, spanning a range of prominent ideas in the current policy debate—from aggressive market regulation to guaranteeing free primary care—and asked how much of a priority each should be. Every policy we tested generated overwhelming support, with at least 74 percent of voters calling each one a priority. The American electorate, in other words, is not conflicted about whether Washington should act on healthcare costs.
But within that consensus, a clear hierarchy emerged: the policies that performed best focused on protecting people from being ripped off. The top two performers—stopping hospital price-gouging and banning surprise billing—dominated the field both on breadth (the share calling them a priority at all) and intensity of support (the share calling them a top priority).
Figure 5
Hospitals shouldn’t be a third rail of healthcare reform—they should be a core focus
The findings on stopping hospital overcharging deserve particular attention. Two in three Americans (67 percent) believe stopping hospitals from charging excessive prices should be a top priority for the federal government, a full seven points and fourteen points higher, respectively, than the second- and third-best-performing ideas we tested (banning surprise billing and capping insurance profits). Support is also deeply cross-partisan: 71 percent of Democrats think it should be a top priority, as do 66 percent of Republicans and 62 percent of independents. Three in four rural voters (75 percent) think it should be a top priority, as do 70 percent of women, 73 percent of Republican women, and 77 percent of Baby Boomers.
While politicians in both parties tend to target pharmaceutical companies and insurers as the primary villains behind rising healthcare costs, leaders are much more willing to give hospitals a pass. This is a mistake—both in terms of where voters are at as well as fully capturing who is actually responsible for spiraling healthcare costs. As The Century Foundation’s Jeanne Lambrew details in a new piece, hospital prices are the leading driver of rising healthcare costs in recent years: from 2006 to 2023, hospital prices grew twice as fast as prescription drugs and insurance prices. At the same time, lobbying spending by hospitals has risen sharply, now ranking sixth highest by industry, and there has been a rapid increase in hospital concentration, which has contributed to the decline of key services in many parts of the country, such as maternity care in rural areas.
Conclusion
These results do not exist in a vacuum. They reflect a decade-plus of consolidation in American healthcare that has transformed it into one of the most concentrated corporate sectors in the economy. Hospital systems have merged into regional monopolies, private equity firms have bought up emergency rooms and physician practices, and the largest insurers have vertically integrated such that the same conglomerate often employs the doctor, approves (or rejects) recommended treatments, and pockets the difference. Prior authorization denials, surprise bills, and opaque pricing are not glitches in the American healthcare system—they are the predominant business model.
Our survey shows that the American public has reached its own verdict on that model. Two-thirds of voters want major change, including new public insurance options or a complete overhaul of the system, and a plurality says that simply reversing the Trump administration’s changes does not go far enough. Americans across every partisan and demographic line want the federal government to take aggressive action to end corporate abuses in healthcare, with stopping hospital price-gouging at the top of the list. Voters want leaders to offer a credible plan that doesn’t merely tinker around the edges, but aggressively challenges the deeply broken status quo.
Methodology
The poll was conducted by Morning Consult from May 21 to May 24, 2026 among a sample of 2,002 registered voters in the United States. The interviews were conducted online and the data were weighted to approximate a target sample of registered voters based on gender, race, age, children in household, educational attainment, marital status, home ownership, region, and 2024 presidential vote.
Results from the full survey have a margin of error of plus or minus 2 percentage points; margins of error for subgroups are larger. Questions about employer-sponsored insurance were asked of the 630 respondents who receive coverage through their or a family member’s employer. Data characterizing the share of respondents taking “at least one” action were calculated as the complement of respondents selecting “none of the above” on the relevant select-all-that-apply battery. Full toplines and crosstabs are available upon request.
Notes
Tags: polling