Policy Tracking – September 2025

Overview

This survey, fielded in early September 2025, includes 1,015 responses, making up a representative sample of U.S. adults (18+), with a margin of error just over 3%.

In short, providers have a tightrope to walk. They need to speak out on healthcare issues, but at the same time, so many things are viewed through a partisan lens that it’s really complicated to wade in without politicization.

A key opportunity for healthcare organizations is in the section “Consequences of Loss of Insurance.” Many do not make the connection that fallout from events affecting others, such as loss of insurance, will ultimately affect their own healthcare by putting greater pressure on the entire system.

We’re recommending providers frame their comms with the following three considerations in mind:

1. Articulate a clear picture of where an organization is going, with patients and communities – not the business of care – front and center. Healthcare organizations should lead conversations about healthcare in their communities rather than sitting back and taking the blame for healthcare’s problems.
2. Emphasize Community Impact. Make it personal. Make it local. The narrative of community impact should be about people, not numbers. To move the needle on perception, highlight the local, human stories that demonstrate a commitment to mission, not money.
3. Communicate clearly about the good and the bad. With a forward-looking story about key decisions, even (especially) the hard ones, an organization can paint the picture about how it’s making the future the best it can be and is making a positive difference.

Angles to consider:

• Highlight local initiatives that make care more accessible.
• Move away from finances and towards patient impact.
• Emphasize shared values.
• Educate on the ripple effects – policies that affect someone else’s healthcare will eventually affect yours, too.

Key findings

1. Healthcare Remains a Top Public Issue, with Cost Front & Center

Healthcare continues to rank just behind the economy as a top national concern. Cost and access dominate the conversation: three-quarters of respondents say healthcare is unaffordable, and 70% say it is not equitable. Only one in three Americans believes the U.S. healthcare system is fair, with rural residents nearly 20 points more likely than urban dwellers to see the system as unfair.

A growing majority blame payers (54%, up from 49% a year ago) and pharmaceutical companies for rising healthcare costs. Fewer blame inflation (30%, down from 38% a year ago). Despite this, the public still sees hospitals as financially healthy and profit-driven. Two-thirds say hospitals are doing well financially, and only one-third believe hospitals prioritize caring for patients. While that last number is an improvement from the low in our tracking survey (24% in January), hospitals remain deeply underwater on the question of patients over profits.

Takeaway: Hospitals should acknowledge economic pressures and lead with empathy and understanding rather than data. Communications should connect affordability and access challenges to the organization’s mission, showing how local providers are working to ease those burdens for patients and families. At the same time, hospitals must reframe their financial story. Rather than focusing on balance sheets, emphasize how financial stability enables community benefit – staffing critical units, supporting rural facilities, not just providing medical care but also supporting health, etc.

2. Public Sentiment on Policy and Government Action

Across policy numerous policy changes, including ACA subsidies, Medicaid cuts, reduced research funding and restructured vaccine policy, between 43% and 54% of Americans expect negative outcomes. Conversely, between a quarter and a third expect these changes to have a positive effect on U.S. healthcare. Not surprisingly, these perceptions are deeply polarized, leaving hospitals at risk of being caught in the crossfire. This creates a challenging environment for political action, because any given legislator’s base is largely entrenched in their position, minimizing the incentive for action or compromise.

Takeaway: Hospitals should stay out of the partisan fray but remain clear-eyed and communicative about policy consequences, focusing on human impact and local outcomes.

3. The Power of Specificity and Personalization

The above reactions were in response to general questions about the various policies. But when shown specific potential consequences to Medicaid cuts, such as rural hospital closures, loss of access to care and healthcare worker layoffs, concern increased. Between about two thirds and three quarters expressing concern that these scenarios would take place. This finding underscores that specificity pushes people to think about the issues and develop more concrete positions.

Takeaway: Hospitals should localize national issues, use stories over statistics, and make communications personal and tangible.

4. The “Insurance Ripple” Blind Spot

While 61% of Americans recognize that other people losing insurance coverage negatively affects healthcare broadly, fewer than half say it would affect their own care. This disconnect highlights a significant education and messaging gap, where the American public does not see the through line from loss of (someone else’s) insurance to increased strain on the system to outcomes that could affect them – loss of services, increased wait times, etc.

Takeaway: Hospitals should communicate the interdependence of the healthcare ecosystem, using campaigns that clarify why insurance coverage matters for everyone, not just the uninsured. This is a key point for us to emphasize. Again, we need to make things personal and local – show people how these issues will affect them, even if on paper they see no change to their healthcare.

5. Declining Confidence and the Path to Rebuilding Trust

Confidence in hospitals’ ability to deliver quality care dropped by eight points to 45% after respondents were asked the questions about policies and potential outcomes. And, just over half (53%)  agree that local hospitals meet their needs today. Positively, though, hospitals and clinicians remain the most trusted voices on healthcare policy.

Takeaway: Hospitals should leverage trusted messengers like nurses and doctors, emphasize local stewardship, and be responsibly transparent – sharing both successes and challenges in a forward-looking way.