Smash the health care cartel, free the market

Obamacare was supposed to solve the problem of a small minority of people who couldn’t afford health insurance but weren’t eligible for Medicaid. Fifteen years later, Democrats now admit their plans are so expensive that unless taxpayers cover nearly the entire cost, they remain unaffordable.

Instead of regulating and subsidizing the market into insolvency, Republicans should finally offer a bold alternative to the largest sector of the economy and the most expensive line in a household budget.

$40 billion a year goes to insurers to pad numbers and keep insolvent plans alive.

News of a possible government shutdown dominates headlines, but few understand what triggered the standoff over fiscal year 2026 funding. Democrats insist that Biden’s COVID-era expansion of Obamacare subsidies be extended or made permanent. In other words: more debt to prop up a broken system. Just what we need.

Subsidizing greed, debt, and inflation

Through the 2021 COVID bill and the Orwellian-named 2022 Inflation Reduction Act, Democrats raised the income cutoff for subsidies from 400% of the federal poverty line to 800%. That’s roughly $300,000 for a family of five. The change placed nearly everyone outside employer coverage under government subsidies. Millions now pay nothing for premiums. The bill goes straight to the national debt.

Insurers responded as any vendor feeding at a public trough would: They raised prices. Family premiums have jumped 20%-25% since 2021, with another 6.5% hike expected next year — the largest increase in 15 years. Because government, not consumers, is now the customer, companies treat subsidies as free money. The result: Health care drives the deficit spending that makes everyday living more expensive.

Small businesses suffer most. Employer plans aren’t subsidized, so workers lose potential wage increases to soaring premium costs. Since 2014, family premiums have climbed 52%, the worker’s share 31%. Deductibles for individual plans have surged 53%, reaching $1,787 in 2024.

The grift goes farther. Paragon Institute data shows that nearly 12 million enrollees never used their coverage. Before Biden’s credits, only 4 million filed no claims. Today, 45% of the 24.3 million exchange “enrollees” are phantom accounts — people auto-re-enrolled, some without even knowing it.

Free money fuels fraud

Once Biden pushed full subsidies for those earning up to 150% of poverty — 55% of 2025’s enrollees — brokers saw a jackpot. With clients paying nothing, brokers collected thousands in commissions per sign-up. Some pocketed $6,000 per plan. Insurers happily billed the government while HHS looked the other way. Paragon estimates that 6 million people received full subsidies despite earning above the threshold.

That means $40 billion a year goes to insurers to pad numbers and keep insolvent plans alive.

RELATED: Medicaid for millions, misery for the middle class

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Breaking the cartel

The real fix is simple: Stop inflating prices with subsidies and break the insurance cartel.

With more than 70 million already pushed onto Medicaid, why not put everyone else into one competitive market where consumers choose freely and insurers compete with unregulated plans?

Trump and congressional Republicans should counter Democrats’ proposal with a market-based plan that:

• Allows insurers, employers, trade associations, and states to offer unregulated alternatives — including expanded “short-term” three-year plans revived from Trump’s first term.
• Expands HSAs by raising contribution caps to $12,000 for individuals and $24,000 for joint filers and allows tax-free use for premiums, concierge fees, and health-sharing ministries. Employers should get equal tax treatment for these alternatives.
• Demands price transparency by prohibiting contracts that block providers from offering discounts to self-pay patients. Repeal the HMO Act and subject managed-care giants to antitrust law.
• Lifts the ban on physician-owned hospitals to restore competition and shore up rural care.

Federal health spending has ballooned from $85 billion in 1987 to nearly $1.5 trillion today — double since Obamacare. Employer-based insurance, warped by government tax policy, adds another $1.1 trillion. More subsidies will only deepen the hole.

Republicans should seize the chance to present a real alternative: consumer choice, price transparency, and competition. That’s the only way to bring health care costs down without bankrupting families or the nation.