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Healthcare

No American should
go broke getting well.

The United States spends more per person on healthcare than any other developed country. We get worse outcomes. 27 million people have no insurance at all. This is not a tragedy. It is a choice - and we can make a different one.

The Crisis in Numbers

The richest country on Earth.

With the most expensive, most inaccessible healthcare system in the developed world.

27M

Americans with no health insurance - more than the entire population of Australia

$13,493

Average annual healthcare spending per American - twice the average of peer nations

500K

Personal bankruptcies annually tied to medical debt - virtually nonexistent elsewhere

1 in 4

Americans who rationed or skipped prescription medication due to cost in the past year

Why This Happened

The healthcare industry owns Congress.

The United States is the only wealthy democracy without universal healthcare. This is not because we lack the resources - it's because pharmaceutical companies, insurance companies, and hospital systems spend over $600 million per year lobbying Congress to prevent any meaningful reform.

The Affordable Care Act was a significant step - it extended coverage to 20 million Americans - but it left the fundamental problem intact: a for-profit system with no obligation to provide care when care conflicts with profit. Drug prices in the U.S. are 2-3 times higher than in Canada, Germany, or the UK - for identical drugs from identical manufacturers.

Project 2025 proposed gutting Medicaid expansion, eliminating ACA subsidy enhancements, and converting Medicare to a "premium support" (voucher) model that would shift costs onto seniors. These were not budget proposals. They were transfers of wealth from sick people to insurers.

What Project 2025 Did to Healthcare

  • Proposed converting Medicaid to a block grant - effectively cutting benefits for 90 million Americans
  • Eliminated the Inflation Reduction Act's Medicare drug price negotiation - handing price control back to pharma
  • Rolled back ACA subsidy enhancements, causing 5+ million people to lose coverage
  • Weakened FDA authority over drug approvals in favor of "accelerated approvals" without evidence requirements
  • Eliminated reproductive health coverage requirements and reinstated gag rules on providers

The Plan

What Project 2029 proposes.

Based on Chapter 14 (HHS) of Project 2029. Specific legislation. Real legal authority. A plan that can actually pass.

1

Medicare Public Option

Universal coverage within reach - without waiting for a revolution

Establish a robust Medicare public option available to every American, regardless of employment status. Priced at actuarial cost, with income-based subsidies ensuring no American pays more than 8.5% of income on premiums. Open to individuals, small businesses, and large employers. This creates genuine competition that forces private insurers to lower prices and improve coverage - or lose customers.

Legal Authority: Social Security Act (42 U.S.C. § 1395); Article I spending power; Commerce Clause
2

Medicare Drug Price Negotiation - Expanded

End pharmaceutical extortion

Build on and strengthen the Inflation Reduction Act's drug pricing provisions. Expand Medicare negotiation authority to all drugs with no patent exclusivity limits. Cap insulin at $35/month for all Americans, not just Medicare beneficiaries. Allow Medicare to negotiate prices based on international reference pricing - anchoring U.S. prices to what other wealthy countries pay. Impose an 80% excise tax on pharmaceutical companies that refuse to negotiate in good faith.

Legal Authority: Inflation Reduction Act (P.L. 117-169); Social Security Act § 1847A; Commerce Clause
3

Medicaid Protection and Expansion

Guarantee coverage for the most vulnerable - no block grants, no cuts

Codify Medicaid expansion in all 50 states through federal incentives and penalties. Prohibit conversion to block grants by statute, requiring Congressional supermajority to change. Expand Medicaid to cover dental, vision, and hearing for all enrollees (extend the ACA's senior dental expansion to all age groups). Eliminate the five-year bar on Medicaid for legal immigrants. Establish a federal floor for Medicaid payment rates at 90% of Medicare rates.

Legal Authority: Social Security Act Title XIX (42 U.S.C. § 1396); NFIB v. Sebelius (2012); Spending Clause
4

Mental Health Parity Enforcement Act

Treat mental illness like any other illness

Strengthen the Mental Health Parity and Addiction Equity Act (MHPAEA) enforcement with civil penalties up to $1M per violation per day. Require insurers to cover all DSM-5 diagnosed mental health conditions with no prior authorization for the first 10 sessions. Eliminate prior authorization for substance use disorder treatment and residential mental health care. Add 10,000 community mental health workers to the National Health Service Corps. Provide $20B over 5 years for community mental health center infrastructure.

Legal Authority: MHPAEA (29 U.S.C. § 1185a); ACA § 2726; Employee Retirement Income Security Act
5

Reproductive Healthcare Protection Act

Abortion is healthcare. Treat it like it.

Codify Roe v. Wade protections in federal statute. Restore and expand Title X family planning funding to $1.5B annually. Require all hospitals receiving federal funds (virtually all of them) to provide emergency reproductive care. Eliminate the Hyde Amendment - prohibiting abortion coverage for Medicaid beneficiaries is a class-based restriction that violates equal protection principles. Protect reproductive healthcare providers from FACE Act violations and targeted harassment.

Legal Authority: Spending Clause; Civil Rights Act; 14th Amendment Equal Protection; Whole Woman's Health v. Hellerstedt (2016)
6

Rural Healthcare Access Act

Geography should not determine survival

Rural hospitals have closed at a rate of one per month for the last decade. 30 million rural Americans have inadequate access to emergency care. Project 2029 proposes: $15B Rural Hospital Stabilization Fund; full telehealth expansion with permanent coverage under Medicare/Medicaid; 5,000 new Primary Care loans under NHSC for rural placements; and mandatory Medicaid payment rate floors to prevent rural hospital payment shortfalls.

Legal Authority: Hill-Burton Act; Social Security Act; Rural Health Care Act; Appropriations power

Take Action

What you can do right now.

Vote for Coverage

Every federal election is a vote on healthcare. Register and vote in every election - including primaries.

Register to Vote →

Demand Medicare Expansion

Call your senators and representative. Ask them specifically: will you support a Medicare public option?

Find Your Rep →

Share the Facts

Download the healthcare one-pager. Share it. Every person who understands the issue is an asset.

Get One-Pager →

Read the Full Chapter

Chapter 14 of Project 2029 - the complete HHS reform blueprint with full legal citations.

Read Chapter 14 →

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