The 2026 midterms are months away, but the focus of the healthcare debate has already been cemented, and affordability is at the top of the list.
Nearly two-thirds of Americans say they worry about being able to afford healthcare (KFF, April 2026). Premiums are rising. Prescription drug costs remain a concern. And changes to Medicaid and ACA coverage added new uncertainty.
For healthcare communicators, there’s another topic to prepare for: what happens to access when people can no longer afford care.
Affordability and access tend to get talked about as separate healthcare problems, but for patients, they are one and the same.
We know that when coverage becomes more expensive or harder to maintain, people make different decisions about their care. Every time a patient puts off an appointment, waits to fill a prescription, or delays treatment, they sometimes end up seeking care later, when they’re sicker, and their options may be more limited.
This creates more pressure across our already strained healthcare system. And that creates a communication challenge that is harder than simply explaining what a new policy does.
Find Your Access Story Now
If affordability is going to dominate the healthcare conversation, communicators should be thinking now about how those pressures could show up among the people and communities their organizations serve.
We don’t need to look into a crystal ball. When affordability dominates the conversation this long, access is what comes next, and healthcare communicators should be determining how that plays out among their audiences now, before the news cycle changes. This is when communicators should look to identify the data, patient experiences and clinician perspectives that can help tell that story, and understand where the organization has something credible and meaningful to add to the conversation.
The goal is to know what your organization is already seeing and be ready to talk about it when the broader conversation catches up. Organizations that wait until access dominates the conversation will be reacting to a narrative someone else has already framed, rather than shaping it themselves.
Know What Access Means to Your Audiences
Most stakeholders aren’t looking for the organization’s position on the election. Employees want to know what a benefits change means for their paycheck. Patients want to know whether their coverage holds. Community partners want to know whether a funding shift reaches the clinic down the street.
Take one example. Beginning January 1, 2027, adults who qualify for Medicaid through the ACA’s expansion, rather than through the program’s traditional eligibility rules, will need to meet new work-reporting requirements. Their eligibility will also be redetermined every six months instead of once a year, and states can choose to start enforcing both changes even sooner (Georgetown University Center for Children and Families). A specific date like that is exactly the kind of detail patients actually need, and it’s the kind of detail a policy explanation often leaves out.
Most healthcare organizations are built to explain the policy. The communications opportunity is to go one step further and connect the policy or regulatory change to what a particular patient, employee, clinician, or community may actually experience. That’s where communications is key, and trust is earned.
Prepare Executives To Talk About What They’re Seeing
Healthcare leaders are going to field questions about access they haven’t rehearsed.
An executive who has never had to comment on drug pricing policy may first field it from a reporter, at an employee town hall, or both in the same week. A clinical leader may suddenly be asked what a policy change could mean for their patient. Those moments call for a specific skill: talking about a policy without sounding like you’re taking a side, which is harder than it looks and rarely practiced until it’s needed live. (We teach this in media training!)
Evaluate spokesperson readiness now, while there’s time to prepare rather than react, and don’t limit that prep to media training alone. The same message needs to hold up in a reporter’s follow-up question and in an all-hands Q&A, often in the same week.
Don’t Wait Until the Story Breaks
Election cycles shorten how long communicators have to respond. A policy proposal that used to take a week to generate press questions can now take hours.
Teams caught flat-footed are usually discovering, in real time, that their approval chain has four signoffs and their fastest spokesperson is out of office.
Pressure test that process before it’s actually under pressure. Know which access-related issues could affect your organization, who is cleared to talk about them, and refresh the messages that are likely to be tested.
No one can predict who wins in November, and we don’t need to. We just need to be able to respond, regardless of the state of play.
Affordability Is the Headline. Access is the Story to Watch.
Whether the ACA premium tax credits get restored or stay expired, or drug pricing legislation advances or stalls, we predict affordability will continue to dominate the healthcare debate through November and beyond. But those numbers only tell part of the story.
As the national conversation plays out, the narrative will change to whether patients can get care, whether clinicians can deliver it and whether communities have access to the healthcare resources they need.
For healthcare communicators, now is the time to understand how that story is playing out in your own organization, and make sure you’re ready to tell it when the conversation shifts.
