Nonprofit health foundations report unprecedented spikes in aid requests—months before federal subsidy expirations and Medicaid reductions threaten to widen care gaps nationwide.
Charities that help Americans pay for medical care say they are experiencing a dramatic increase in requests for financial assistance—an early warning sign of what public health experts fear could become one of the most significant medical-debt crises in years.
The surge comes before two major shocks scheduled for 2026:
- The expiration of enhanced Affordable Care Act (ACA) subsidies, and
- Nearly $1 trillion in Medicaid cuts were included in President Donald Trump’s One Big Beautiful Bill Act.
Nonprofits warn that without congressional intervention, medical debt, delayed diagnoses, and preventable deaths could increase markedly.
“This is a national-scale alarm,” said Michael Sapienza, CEO of the Colorectal Cancer Alliance. “Our organization can’t handle much more demand.”
Charities Are Already Overwhelmed—and the Cuts Haven’t Started Yet
The HealthWell Foundation, one of the largest medical-assistance charities in the U.S., reports that requests for help are already 23% higher in 2025 than in all of 2024.
A new fund, HealthWell, launched this month—aimed at offsetting ACA premium increases if subsidies expire—was flooded with applications and closed after only 48 hours.
Other nonprofits echo the trend:
- Colorectal Cancer Alliance: requests up 26% year-over-year
- CancerCare: requests up 10%
- ThriveWell Cancer Foundation: turning away three in four patients due to insufficient resources
“We don’t see the demand curve flattening,” said HealthWell CEO Michael Heimall. “Economic tightening affects donors as much as patients.”
Rising Costs, Higher Deductibles, and Widening Gaps in Access
Even though most Americans are insured through private plans, Medicare, or Medicaid, nearly half of U.S. adults report concern about affording care next year, according to a new 'TELL IT LIKE IT IS' Health News–Public First poll.
Key poll findings:
- 48% worry about paying for health care in 2026
- 1 in 5 say care is already “very difficult” to afford
- Deductibles continue to rise faster than wage growth
Academics say these pressures are cumulative.
“It’s built up over time with no relief,” said Vivian Ho, chair of health economics at Rice University’s Baker Institute. “The system isn’t addressing the underlying structural drivers of high health-care costs.”
Enhanced ACA subsidies created during the COVID-19 pandemic made coverage more affordable and expanded eligibility beyond the traditional 400% of the poverty level cutoff.
If Congress lets them lapse:
- ACA premiums for 2026 have already risen 26% on average, according to KFF.
- 4 million people may lose coverage, according to the Congressional Budget Office.
- Charity leaders warn of “avoidable mortality” if patients skip screening or treatment.
Several nonprofits—including the Patient Access Network Foundation, Blood Cancer United, and the Colorectal Cancer Alliance—are publicly urging Congress to extend the subsidies.
“These Americans’ lives are too important to hang in the balance,” Brian Connell of Blood Cancer United told lawmakers.
The group spent $1.3 million on lobbying in the first nine months of 2025—its highest on record.
Medicaid Cuts Could Remove 10 Million People From Coverage
The One Big Beautiful Bill Act, passed in July, reduces federal Medicaid funding by nearly $1 trillion over 10 years. The Congressional Budget Office projects:
- 10 million people could be dropped from Medicaid by 2034
- Many will lose coverage due to new work, volunteer, or educational requirements beginning in 2027
For patients facing cancer, chronic disease, or high-cost medications, losing Medicaid coverage could be catastrophic.
“People will not survive diagnoses that are highly treatable today,” said ThriveWell’s executive director Erin Ercoline. Her organization provided $2.2 million in patient aid this year—near pandemic-era highs.
Administration Response: White House Blames Democrats; Drug Price Deals Announced
The White House argues that Democrats’ approach funnels resources to insurance companies and does not address affordability. Officials point to recent negotiations with major pharmaceutical companies—Pfizer, Eli Lilly, and AstraZeneca among them—that promise reduced prices on 15 high-cost Medicare drugs starting in 2027.
The administration estimates $685 million in savings for Medicare beneficiaries.
A Looming January Surge—With No Agreement in Sight
The enhanced subsidies expire on January 1 unless Congress acts. Multiple proposals are circulating, but none appear to have enough support to pass.
Meanwhile, charities preparing for a “January surge” say their funds are already depleted.
“This is the worst timing possible,” said Ercoline. “People are going to skip screenings, stop treatment, and die from conditions that should be survivable.”
Public health experts warn that financial barriers to care are among the strongest predictors of poor outcomes—especially for cancer, heart disease, diabetes, and chronic lung conditions.
Without intervention, they say, the U.S. could face a measurable decline in population health by mid-2026.
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-- By Cierra Jacobs
© Copyright 2025 JWT Communications. All rights reserved. This article cannot be republished, rebroadcast, rewritten, or distributed in any form without written permission.
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