Making coverage more affordable will require policy reforms that reestablish competitive markets, realign incentives, and place consumers—not government or consolidated health insurers or systems—at the center of the health care marketplace.
CAHC will advance policies that expand competition, empower consumers, and restore market forces so that coverage and care become increasingly affordable for all Americans.
Break Up Monopolies
Competitive markets do more to lower drug costs and improve access to care than government price controls. Our reforms address well-known challenges and get more gMost people believe we have free market health care, yet most markets are uncompetitive with local and national monopolies that wield market power to drive costs ever higher. The Trump Administration should use its power under competition laws to break up vertically integrated systems, and Congress should address policy drivers in the Inflation Reduction Act and the ACA that have destabilized markets and rewarded scale.
Transparency First
Consumers cannot shop for value without knowing prices. Congress should require full price and quality transparency for all services and drugs in every market—before care is delivered. If insurers or providers refuse to disclose prices, they should not get paid. Research shows 89 percent of consumers want to shop for care, and up to half would switch providers for a better price. Transparency is the foundation for a functional market.
Real Choice in Coverage
Consumers and small businesses should be able to buy any plan approved for sale in a state. Congress should give states additional flexibility to design their markets, and remove statutory barriers to high-risk pools, Association Health Plans, ICHRAs, catastrophic and term policies, direct primary care arrangements, sharing plans, and HSAs. This shifts individuals from renters of coverage to owning their health care.
Consumers Before Companies
Federal and state money should go directly to consumers, not big companies. Restoring subsidy portability – and allowing people to use federal assistance to buy any state-approved plan that meets a basic actuarial standard – would force companies to compete on price and service rather than rely on regulatory protection.
Lower Medical Costs
Affordability requires more care options and lower underlying prices. Congress should eliminate incentives that drive medical inflation: unchecked hospital consolidation, site-of-service payment disparities, 340B abuses, anticompetitive contracting, and vertically integrated systems that hide costs and raise prices. Expanding the supply of providers and care settings reduces prices and expands access.
Freedom to Pay Less
If a patient finds a better price and pays cash – through platforms like TrumpRx or similar tools – those purchases should count toward their insurance out-of-pocket obligations. No one should be penalized for securing a better deal.