The Polling Numbers Behind Hospital Reform

High health care costs are top of mind for voters and employers across the country. And three separate polls show that voters strongly favor a series of aggressive reforms aimed at one thing: putting hospital prices in check to combat these high costs.

Prices for hospital services are at an all-time high, growing faster than prescription drugs and nursing care. They are pushing up insurance premiums and deductibles. Data from Arnold Ventures, Small Business Majority, and United States of Care, shows that voters—Democrats and Republicans alike—support reforms to limit hospital prices. Below, we unpack the numbers from those polls and show how Congress can deliver wins to voters with policies that make hospital prices transparent, fair, and competitive.

Voters Want Transparency

When customers go to a grocery store, movie theater, or restaurant, prices aren’t hidden until it’s time to pay. So why do hospitals think they can completely hide the price of care? In 2019, the Trump Administration enacted transparency rules for hospital prices that would require them to make their prices available to the public. Only one-third of hospitals are currently in compliance.

Voters want that to change. According to polling from Arnold Ventures, 87% of voters are in favor of requirements for hospitals to disclose their prices. This includes 90% of Biden voters and 86% of Trump voters. Ninety-six percent of small business owners support disclosure, according to the Small Business Majority.

Congress should ensure hospitals are complying with federal transparency rules. The Lower Costs, More Transparency Act, which was passed by the House last December, would codify and strengthen price transparency rules. Similar provisions were passed in the Senate Health, Education, Labor, and Pensions (HELP) Committee as part of the Bipartisan Primary Care and Health Workforce Act.

Voters Want Fair Prices

As hospitals acquire physician practices and convert them into hospital-owned clinics, patients are stuck paying more for the same care. With over half of physicians now employees of hospitals, seniors in Medicare are paying up to four times more for services that can be safely performed in independent physicians’ offices.

Voters don’t think that’s fair and overwhelmingly support limiting outpatient fees to the same price charged by independent doctors in the community. Specifically, Arnold Ventures polling finds that 85% support limiting outpatient fees, including 89% of Biden voters and 82% of Trump voters. United States of Care polling also showed strong support for tackling hospital fees, with 77% supporting banning them at hospital-owned clinics and 74% supporting banning them everywhere. Almost nine in 10 small business owners support banning hospital "facility fees" and other unfair billing practices. And 78% support Medicare reimbursing hospitals the same price for the same service, regardless of where the service is performed.

Congress has numerous avenues to ensure the same service costs the same price. In addition to strengthening transparency rules, the Lower Costs, More Transparency Act also would create same service, same price policies for drug administration in Medicare, saving cancer patients $300 a year on average. Separately, Senators Mike Braun (R-IN) and Maggie Hassan (D-NH) introduced the Site-based Invoicing and Transparency Enhancement (SITE) Act to extend this policy to all reasonable services in Medicare. In the private sector, the SITE Act would also require hospitals to bill honestly from the correct location that care takes place, as opposed to billing from their higher priced locations by default. The Senate HELP Committee package also includes a ban on facility fees for telehealth and evaluation/management services.

Voters Want Hospital Competition

As a result of consolidation within hospital markets, two-thirds of hospitals are now part of larger systems. That means patients and employers have less leverage to fight rising prices. Hospitals can continue raising their prices and buying out their competition, including physician practices and other hospitals. They also can prevent health plans and employers from selecting higher-value and lower-cost hospitals in their networks.

Voters support policies to improve competition and lower prices. Arnold Ventures found 75% of voters support preventing hospitals from engaging in business tactics that reduce competition, including 80% of Biden voters and 72% of Trump voters. They also found that strengthening oversight of hospital mergers and acquisitions polls at 74%, including 78% of Biden voters and 72% of Trump voters. And 75% of small businesses support greater government authority to block mergers and acquisitions in health care.

In Congress, the Senate HELP Committee health care package would ban anticompetitive terms in hospital network contracts. Standalone legislation in the House and Senate, the Healthy Competition for Better Care Act, has been introduced by Senators Mike Braun (R-IN) and Tammy Baldwin (D-WI) and Representative Michelle Steel (R-CA). Representatives Pramila Jayapal (D-WA) and Victoria Spartz (R-IN) introduced the Stop Anticompetitive Healthcare Act to give the Federal Trade Commission antitrust authority over nonprofit hospitals.

Strengthening transparency, paying the same price for the same service, and promoting competition are policies that incredibly popular with voters and small business owners. Congress should act promptly to pass legislation to do so to lower hospital prices and create a more affordable health care system for all Americans.