More than a decade ago, Democrats pushed through the Affordable Care Act, vowing to save us $2,500 on our insurance premiums while allowing us to keep our doctors and health insurance plans. All of that wasn't true, and health insurance premiums and healthcare costs have skyrocketed. According to the America First Policy Institute (AFPI), individual health expenditures were expected to reach roughly $16,570 per person by the end of 2025, with more increases coming.
Democrats insist the solution to this problem is more government, with Medicare for All eliminating private insurance in favor of socialized, single-payer healthcare. But before it's an ideological issue, healthcare is an affordability ssue.
And according to recent polling, 88 percent of voters want patients and doctors — not Washington — making healthcare decisions for them. Polling also shows 92 percent of voters support "making healthcare affordable and accessible, keep rural hospitals open, lower regulations, expand telehealth, and improve access in underserved communities"; with 91 percent saying families shouldn't have to choose between groceries and medical bills.
On specific reforms, 90 percent support taking on high prescription drug costs, while 91 percent want faster generic competition, 87 percent want hospital price transparency, and 86 percent want greater competition.
Hannah Anderson, Director of Healthy America Policy at AFPI, testified before a House Subcommittee in April that undisclosed financial relationships between pharmacy benefit managers (PBMs), brokers, and benefits consultants are contributing to higher prescription drug costs for the 154 million Americans covered by employer-sponsored health plans. "Perverse incentive are driving up costs for patients," Anderson said. She also noted that President Trump's Great Healthcare Plan will end kickbacks between PBMs and agents and brokers.
The Trump administration has already taken steps towards lowering drug costs. TrumpRx and his May 2025 executive order directing pharmaceutical companies to offer Americans "most favored nation" pricing (or the lowest price charged in other developed countries). TrumpRx made direct-to-consumer prescription drug pricing a reality, with 16 of 17 of the largest pharmaceutical companies on board with the plan, including AstraZeneca and Eli Lilly. On May 18, President Trump announced that more than 600 generic medications would be added to TrumpRx.
And in August, we learned that prescription drug prices in America reached a 60-year low, thanks to President Trump's policies.
Competition and lowering costs expands far beyond pharmaceuticals. The Federal Trade Commission (FTC) recently required Ascension Health Alliance (Ascension) to divest from seven AmSurge ambulatory surgery centers in Nashville, TN; Panama City, FL; Tulsa, OK; Waco, TX, and Witicha, KS. The FTC ordered this because the acquisition of AmSurg would "limit competition for certain outpatient surgical services performed by gastroenterologists, ophthalmologists and orthopedists" across those cities and "lead to higher surgery prices for patients, while also threatening to lower the quality of care and limit surgical services innovation."
Another area of focus is strengthening rural hospitals that provide important and life-saving care. More than half of all hospitals in the United States are in rural areas. According to the Health Resources & Services Administration (HRSA), 152 rural hospitals have closed between 2010 and 2025. HRSA provides technical assistance and support to these hospitals, including grant funding to states to support rural hospitals.
The ultimate goal of reforming healthcare and affordability should be to put the patient back in the middle. By allowing greater competition, lowering prescription drug costs, working on hospital price transparency, and supporting rural hospitals and telehealth programs, the path to a high-quality, affordable healthcare system is clear.