Election 2026 Roundtable: The affordability of care

Affordability is more than a defining issue in the Congressional elections.

It’s a gut-wrenching problem for many Americans, especially when it comes to affording healthcare.

In the latest segment from the Chief Healthcare Executive® Election 2026 Roundtable, our panel discussed the high cost of care. It’s part of a wide-ranging conversation about the congressional elections and the impact for healthcare, providers, and patients.

Our panelists:

• Danielle Turnipseed - She’s the chief public policy officer of the AAMC, the Association of American Medical Colleges.
• Robert E. Andrews - The CEO of the Health Transformation Alliance, he spent 24 years in Congress representing part of New Jersey in the U.S. House of Representatives.
• Lisa Kidder Hrobsky - She’s the senior vice president of federal relations, advocacy and political affairs at the American Hospital Association.

The panel examined what the next Congress can do to help Americans as they face rising prices.

‘Keeps Americans up at night’

Turnipseed noted that the elections have been dominated by the question of affordability, from healthcare to groceries.

“Affordability is the key buzzword, certainly on the campaign trail, for both sides of the aisle,” she said. “It actually is a topic that keeps Americans up at night. And people are looking for changes in policy that will impact their lives and help make it easier.”

“I think Congress has to prioritize systemic affordability, because they'll continue to hear about it from their constituents. It's important to realize that there's no one single policy that will make healthcare more affordable. This is a systems approach, so it isn't just an executive order about drugs. It isn't just price transparency. You know, it's popular, but that doesn't get you affordability,” Turnipseed said.

Turnipseed noted that many Americans have dropped coverage due to the expiration of tax credits supporting the Affordable Care Act. More than two million Americans have dropped coverage due to spikes in premiums after the tax credits expired, making plans more expensive.

“Members will continue to hear from people in their districts, and again, I think that is the kind of pressure that Congress will face in order to address affordability,” Turnipseed said.

And she added, “I think one practical thing that Congress can do, and should focus on early, is revisiting those enhanced premium tax credits.”

Other panel members agreed that restoring the tax credits would offer genuine relief and help people pay for care. But they also said it may be difficult to secure support for reviving the credits, particularly with President Trump.

Value-based care

Andrews said he’d like to see the government give health systems more incentive for keeping patients healthier. He says the promise around value-based care hasn’t fully materialized due to a lack of government support.

“The phrase ‘value-based care’ is a hackneyed, overused phrase,” Andrews said. “It's never really been honored. We've gone to providers and basically said, ‘We as a country, we want you to bear the downside risk if people get sick, but not share in the upside benefit if they get healthier.’ Not surprisingly, providers have said we don't really want any part of it, and I don't blame them. You can't run a hospital or a clinic on that.”

Andrews said greater government incentives for prevention would pay dividends, including expanded access to screenings.

“If seniors really got healthier and stayed healthier and had better health outcomes, there would be a reward for the provider system. If that happened, I think the whole system benefits,” Andrews said.

“If you want to cut cancer spending, get everybody screened as early as you can,” he added. “Screening's not all that expensive, but it's really effective. If you want to reduce days in the NICU, get more women really top-notch prenatal care as early in their pregnancy as you possibly can.”

Kidder Hrobsky also said she hopes lawmakers get behind efforts to offer more support for value-based care.

“Finding more competitive or more appealing value-based care programs is really a great idea to bring down the cost and allow the system to work on new ideas and come up with new things that make people healthier and bring down the cost,” she said.

Optimism for bipartisan support

The panelists saw some potential for the next Congress to get behind efforts to make care more affordable and to give incentives for systems to be healthier.

Kidder Hrobsky said it will take a comprehensive approach.

“You have to really look holistically and try to figure out where in the system you can either piecemeal and get buy-in from everyone — as you know, like the pharmaceuticals, the hospitals, the doctors, we're all sort of pointing fingers at one another,” she said. “But I do think that there is a real opportunity, if you want to address affordability, to bring everyone together and acknowledge that we all have to change together.”

Andrews also expressed optimism that lawmakers in the next Congress would tackle the cost of care. He said he could see Democrats and Republicans working together on incentives for value-based care.

“There are ways to do this. If you want to cut cardiology costs, make sure you match the right statin, which is a generic, they're cheap, with people that have heart disease. These are things that are doable, but under the present structure, under the present ground rules, providers are punished for doing those things. They're not really rewarded,” Andrews said.

“So I know a lot of Republican friends who would agree with what I just said. I know some Democratic friends who would agree with what I just said, and I would hope that we could find a way” he said.

Andrews also said the Trump administration has touted the value of keeping patients healthier and out of the hospital. He also envisioned support from Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services.

“There might be ways that we could make the promise of value-based care real for providers, make it worth the risk,” Andrews said. “And I think if that happened, you'd get more cancer screenings … more babies going full term, fewer heart attacks, fewer strokes, and that's how you bring down healthcare costs.”

More insights

Check out the previous installments of our Election 2026 Roundtable.

Segment One: The impact on health policy

Segment Two: Medicaid cuts and rural hospitals at risk