Summary

Hospitals provide essential services and are vital to the well-being of our communities. However, a recent survey of over 1,200 Maine adults, conducted from January 13 to February 19, 2026, revealed widespread concern about the cost of hospital care, a lack of confidence in navigating the health care system, understanding their cost sharing obligations, and bipartisan support for government-led solutions. These challenges are sometimes attributed to insufficient levels of health insurance literacy¹ or health literacy,² which is associated with poorer health outcomes, lower patient satisfaction and higher costs.³ This brief surfaces respondents’ experiences operating within the health care system, interpreting their cost-sharing obligations and highlights support for related policy solutions.

Concern about Affording Hospital Services

A majority of Maine respondents report being concerned about their ability to afford care. In fact, 82% of Maine respondents reported being worried about affording health care, both now and in the future. Respondents also indicated that they are worried about affording other aspects of care, including:

• Sixty-nine percent (69%) of respondents reported being ‘worried” or “very worried” about being able to afford home health care services;
• Sixty-three percent (63%) of respondents reported being “worried” or “very worried” about affording medical cost when elderly;
• Sixty-one percent (61%) of respondents reported being “worried” or “very worried” about affording medical costs in the event of a serious illness or accident.
• Twenty-six (26%) of respondents reported being “worried” or “very worried” about affording the cost of maternity or reproductive care;
• Fifty-four percent (54%) of respondents reported being “worried” or “very worried” about affording the bill from an ambulance ride in an emergency;

Some respondents also reported cost burdens following care. In total, 37% reported experiencing a financial burden due to medical bills and 27% of respondents reported that they currently have outstanding medical bills. Among the respondents who reported having outstanding medical bills, over half (67%) said at least one of those bills came from a hospital.

Confidence Seeking Hospital Care, Quality, Billing Information

Limited knowledge of health care quality or costs can hinder consumers’ ability to budget for care, which can be especially detrimental to the under- and uninsured.⁴ Maine respondents are fairly confident in their ability to recognize when to seek emergency care, follow directions provided by their doctor, and their ability to fill a prescription. Sixty-three percent (63%) of respondents are very or extremely confident that they know when to visit the emergency department as opposed to an urgent care center or a primary care provider (see Figure 1).

However, respondents are less confident in their ability to find hospital costs and quality information before a service. They are also less confident in their ability to resolve concerns related to financial obligations, such as disputing a medical bill. Out of all respondents:

• Seventy-six percent (76%) of respondents reported they were not confident in their ability to afford home health care services;
• Sixty-nine percent (69%) of respondents reported they were not confident in their ability to have enough money to cover major unexpected illnesses or injuries;
• Sixty-three percent (63%) of respondents feel very or extremely confident they could resolve an issue if their health plan was not being responsive;
• Fifty-five percent (55%) of respondents reported they were not confident in their ability to have enough money to cover their usual necessary medical cost;
• Fifty-four percent (54%) of respondents reported they were not confident in their ability to determine the cost of a medical procedure in advance;
• Fifty-one percent (51%) are not confident in their ability to find quality ratings for doctors; and
• Forty-nine percent (49%) are not confident in their ability to find quality ratings for hospitals.

Difficulty Understanding Common Health Terms

Research indicates that nearly half of insured adults find at least one aspect of their insurance difficult to understand.⁶ When given multiple choices, over three out of four (79% of) Maine respondents were able to correctly define “premium,” and a similar amount (78%) were able to correctly define “deductible.” However, fewer than half (49%) were able to accurately define “coinsurance”(see Figure 4).  Of note, more educated respondents generally performed better when asked to define these terms (see Table 1).

Respondent Perceptions of Health Care Systems, Policy Solutions

Hospitals, along with drug manufacturers and insurance companies, are viewed as a primary contributor to high health care costs. Maine respondents most frequently reported believing that the parties responsible for high health care costs include:

• 81%—Drug companies
• 77%—Health insurance companies
• 54%—Hospitals
• 47%—Medical device manufacturers
• 44%—The state government
• 25%—Doctors
• 12%—Consumers and patients

Seventy-three percent (73%) of respondents believe the health care system is unaffordable and 93% believe health care costs are rising. Respondents reported it is “moderately” or “extremely” important to support, maintain, in some cases expand Medicaid to ensure health care coverage for individuals that need it while keeping an eye on fraud, waste and abuse in the Medicaid system (see Table 2).

There is support for change regardless of respondents’ political affiliation (see Table 3). The high burden of health care affordability, along with high levels of support for change, suggest that elected leaders and other stakeholders need to make addressing this consumer burden a top priority. When it comes to tackling costs, respondents endorsed a number of strategies, including:   

Maine respondents reported support for government-led solutions to make price and quality information more accessible and to help consumers navigate hospital care. Policymakers should consider these and other policy options to address the bipartisan call for government action.