Five Pillars for Affordable Health Care

Public Narrative (Plain Language)

Cut Waste & Paperwork
Doctors, patients, and insurers all waste billions on faxes, forms, and red tape. Streamlined approvals and real price transparency mean faster care and fewer surprise bills.
End Price Gaming
The same service should cost the same, no matter where it’s delivered. We’ll stop hospitals and middlemen from charging hidden fees and ban back-room PBM deals that inflate drug costs.
Strengthen Primary & Preventive Care
Healthy communities start with strong primary care. We’ll invest more in family doctors, prevention, and mental health so patients stay out of the ER and hospitals focus on the sickest.
Stabilize Coverage & Protect Patients
Affordable care depends on stable insurance. That means automatic enrollment options, fairer Medicaid rules, stronger protections against medical debt, and clear bills patients can actually read.
Grow Capacity & Fair Competition
America needs more doctors, nurses, and fairer markets. We’ll expand the health workforce, break up monopoly power, and safeguard rural hospitals with modern payment models.

Prior Authorization Reform: uniform national standards, real-time electronic approvals, strict turnaround times, penalties for non-compliance.
Admin Simplification: standardized forms, ban repeated approvals for chronic meds.
Transparency Enforcement: enforce existing CMS rules with real fines; build public price navigator.
Guardrail: require >90% compliance before allowing employers to base benefit design on transparency data.

Site-Neutral Payments: equal pay for equal services, phased in, with rural carve-outs.
Surprise Billing Gaps: close loopholes (ground ambulance, off-campus facility fees).
PBM Reform: fiduciary duty, ban spread pricing, pass-through rebates, employer audit rights.
Guardrail: if PBMs consolidate further, FTC/DOJ empowered to review contracts for anti-competitive substitution.

Payment Reform: scale primary care capitation, global hospital budgets, bundled payments for high-variance episodes.
Primary Care Investment Floors: require insurers to spend a set % on primary care.
Behavioral Health Parity: enforce parity with dedicated audit funding.
Prevention & Chronic Disease: expand vaccine access, obesity/tobacco programs.
Guardrail: tie floors to total cost-of-care reductions, not just shifting dollars.

Coverage Stability: auto-enroll through tax filing with opt-out; reinsurance for individual markets; 12-month Medicaid eligibility.
Medical Debt Protections: ban small-debt credit reporting; standardized charity care.
Consumer Clarity: one-page plan summaries, plain-language EOBs, multilingual support.
Guardrail: protect choice with opt-out framing to avoid “mandate” backlash.

Workforce Supply: expand GME slots, fast-track visas, interstate licensure compacts, modernize scope-of-practice.
Rural Health Stability: targeted supplements, telehealth parity, global budgets for rural hospitals.
Antitrust Enforcement: FTC/DOJ empowered to block price-raising mergers and unwind past consolidation where justified.
Guardrail: rural global budgets tied to quality floors so hospitals don’t under-deliver.

Sunset Audits: independent evaluation every 3 years; reauthorize/upgrade reforms.
Multi-Angle Oversight: GAO, state AGs, employer coalitions, patient groups.
Public Dashboards: compliance data published in real time.
Coalition Strategy: employers + patients + unions + primary care vs. entrenched hospital/PBM interests.

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