As the American Hospital Association Annual Membership Meeting Convenes in Washington, Consumers for Quality Care urges lawmakers to ensure nonprofit hospitals put patients ahead of profits

WASHINGTON, D.C. – Consumers for Quality Care (CQC), a coalition of advocates and former policy makers working to provide a voice for patients in the health care debate, issued the following letter to members of Congress, urging them to hold nonprofit hospitals accountable as the American Hospital Association convenes in Washington, D.C.

April 20, 2026

As the American Hospital Association convenes in Washington for its Annual Membership Meeting, Consumers for Quality Care (CQC) writes to remind you that no issue matters more to American voters today than affordability, and the rising cost of health care is a big reason why. Not only are Americans paying higher prices for what is often lower-quality care, but more than 100 million Americans are also finding themselves stuck in medical debt, and hospitals are the main driver of these troubling trends. We urge you, as the hospital industry’s most powerful lobby descends on the nation’s capital, to keep the following in mind.

• Hospitals are hiding their prices. Under federal law, hospitals are required to publish their prices online in an easy-to-understand format. Yet when Patient Rights Advocate surveyed 2,000 hospitals nationwide, only 21 percent were in compliance. Roughly 12 percent published no dollar-and-cents prices at all, and more than 75 percent listed at least some of their prices as formulas or algorithms that only industry experts can decipher. 

Without transparency, patients cannot shop for the best price or make informed decisions about their care. This empowers hospitals to inflate costs and overcharge patients, and that’s exactly what they’re doing. RAND Corporation found that hospitals overcharge privately insured patients by more than 60 percent on average, and in 22 states, the average overcharge exceeds 100 percent. 

Stronger enforcement mechanisms and harsher penalties are long overdue. To date, only 28 hospitals have been fined for failing to comply with federal price-transparency rules, and the fines are so small that they are unlikely to deter large hospitals from hiding prices. 

• Hospital mergers are reducing competition and raising costs. There have been more than 2,000 hospital mergers since 1998, and now roughly 68 percent of American hospitals are no longer independent. In nearly half of U.S. metro areas, the local hospital market is controlled by just one or two health systems, and 90 percent of local hospital markets are considered “highly concentrated.” 

Hospital consolidation comes with severe consequences for consumers. Horizontal mergers lead to price increases of 20 to 40 percent, and vertical acquisitions of physician practices drive increases of 14 to 34 percent. Worse, these price hikes come with no improvement in the quality of care and are paid for largely by workers. According to Health Affairs, price increases owing to hospital consolidation cost American workers more than $1 trillion in lost wage income between 2012 and 2022. 

• Nonprofit hospitals aren’t acting like nonprofits. Nearly 60 percent of American hospitals are tax-exempt nonprofits, yet most spend less on charity care as a share of their expenses than for-profit hospitals do. Roughly 80 percent of nonprofit hospitals run a “fair share deficit,” meaning they receive more in tax breaks than they return in charity care and community benefits. In 2021 alone, the collective fair share deficit exceeded $25 billion, enough, according to the Consumer Financial Protection Bureau, to erase almost 30 percent of all medical debt in America. 

Meanwhile, many nonprofit hospitals routinely fail to inform patients they may be eligible for charity care, and 45 percent routinely bill patients whose incomes qualify them for free care. Worse, many nonprofit hospitals will go so far as to sue patients for nonpayment. In fact, a recent study focusing on Virginia found that hospitals were responsible for most debt-collection lawsuits against patients, and that nonprofit hospitals were responsible for a super-majority (87%) of these lawsuits. 

The cumulative effect of these anti-consumer practices is that patients lose while big corporate hospitals win. Patients struggle to discern what their care will cost, while hospitals bury their prices in algorithms and fine print. Patients watch their choices shrink as local hospitals are swallowed by massive health systems, while hospitals use their growing market power to charge higher and higher prices. 

When the hospital industry’s lobbyists visit your office this week, they will tell you that hospitals need more money and fewer regulations. We ask you to consider the other side of that story: American consumers are paying more for health care than ever before, and hospitals are a driving force behind that crisis. 

CQC urges you to stand with patients by strengthening price-transparency enforcement, scrutinizing hospital mergers that reduce competition, and holding nonprofit hospitals accountable for the charitable obligations that justify their tax-exempt status. The hospital industry should not be allowed to put its profits before the patients it is supposed to serve.

Sincerely,

Consumers for Quality Care