Health care costs remain a top concern for American voters, and with midterm elections on the horizon, lawmakers are under growing pressure to deliver meaningful reforms. A recent House Energy and Commerce Subcommittee on Health hearing zeroed in on a core issue: too many government policies funnel money to insurance companies and large hospital systems instead of directly to patients.
Anthony DiGiorgio, a neurosurgeon at UC San Francisco and advisory council member for the advocacy group Fund The Patient, argues that the current system is fundamentally misaligned. “When funding is tied more closely to patients, fewer resources are lost to fraud, administrative bloat, and opaque hospital pricing,” he wrote in a recent analysis. The organization’s latest poll underscores that message, showing that 75 percent of patients believe the health care system is not meeting most Americans’ needs.
The polling data reflects real-world pain. According to The New York Times, one-third of Americans have cut spending in other areas or gone into debt to pay for medical care. Rising premiums are driven largely by hospital consolidation, which has allowed conglomerates to jack up prices. DiGiorgio notes that “rising premiums are not only an insurance story; they reflect exploding hospital prices driven by hospital consolidation.”
Existing subsidy programs often bypass patients entirely. ObamaCare subsidies go straight to insurers, while programs like disproportionate share hospital funding and the 340B drug discount program channel money to hospital systems rather than empowering individuals. The result: patients are left questioning where all the money goes as prices continue to climb.
Fund The Patient’s poll found that 80 percent of respondents support allowing any American to open a health savings account, and nearly two-thirds favor price transparency measures to enable truly shoppable care. These policies aim to redirect subsidies into HSAs, support alternative practice models like direct primary care, and let physicians compete more freely with large hospital networks.
Legislative efforts are already underway. Senators Bill Cassidy (R-La.) and Mike Crapo (R-Idaho) have introduced a bill that would let millions of patients redirect Affordable Care Act subsidy dollars into pre-funded HSAs. Meanwhile, Representatives Kat Cammack (R-Fla.) and Greg Steube (R-Fla.) have proposed expanding HSA eligibility to Americans who currently don’t qualify. Both bills build on the health savings account measures included in the One Big Beautiful Bill, which passed via budget reconciliation earlier this year.
But advocates warn that these steps are just a start. “Americans also need long-term reforms, not just a Band-Aid fix,” DiGiorgio wrote. He points to growing dissatisfaction after more than a decade of mediocre outcomes, and urges lawmakers to use budget reconciliation again to advance patient-centered changes. The poll numbers, he says, confirm what policy experts and patient advocates have been saying for years: fund patients, not health systems.
The political stakes are high. With control of Congress up for grabs in 2026, both parties are eager to claim wins on kitchen-table issues like health care. Redirecting subsidies from corporations to patients could be a tangible victory—and one that resonates with voters who feel the system is rigged against them. As DiGiorgio put it, “Lawmakers need to listen to patients about the direction of health care reform.”
