Washington is running out of time, and Americans are running out of patience.
Half of Americans struggle to pay for health care costs, according to the Kaiser Family Foundation. In fact, today, health care costs are rising faster than wages, premiums are swallowing family budgets, and the federal government is barreling toward a debt crisis fueled by exorbitant federal health care spending.
Tackling these systemic failures is the urgency of this moment, and Republicans have a historic opportunity to use reconciliation to tackle the health care cost crisis that is crushing both our nation’s families and jeopardizing our collective destiny.
In 1975, the federal government spent $19 billion on health care. Since then, federal health care spending has ballooned 100 times to nearly $2 trillion a year—most of it happening after Democrats enacted Obamacare—accounting for about one-third of the federal budget. On current projections, this burden will nearly double in the next decade.
Here’s another way to think about this: before long, Washington will control more than half of all health care dollars spent in America. Demographics alone do not explain why these costs continue to climb; policy choices and perverse incentives do. If we are serious about reversing the curse of public debt, we must stop treating symptoms and finally confront the underlying disease.
Last year, Republicans passed the One Big Beautiful Bill, proving reform is both possible and responsible. This law locked in and enhanced tax cuts for hardworking families and achieved more than $1 trillion in health care savings by closing loopholes, rooting out fraud, and enforcing common-sense eligibility standards while protecting care for the most vulnerable. And for the first time since Obamacare’s inception, Congress reduced premiums.
That success was not an endpoint. It was a down payment on a more solvent future.
Americans today are facing a genuine health care cost crisis, and too many Democrats would rather defend, double down on, and subsidize a failing system than admit that Obamacare is broken, along with the promise of affordability.
The Left will tell you the only answer to this problem is more government regulation, more mandates, and more spending. Obamacare’s advocates promised it would bend the cost curve down; instead, premiums and deductibles have doubled and choices have dwindled. This is not reform—it is rationing, dressed up in nice language.
President Trump has laid out a vision for meaningful health care reforms that all Americans can embrace. “The Great Healthcare” plan rests on four pillars: lower drug prices; lower insurance premiums; hold big insurance companies accountable; and maximize price transparency.
These goals enjoy broad bipartisan support in theory. But, if Democrats are unwilling to work with us in practice, Republicans must use reconciliation to turn those principles into law. With reconciliation, we can rise above the Washington dysfunction and make health care truly affordable for the American people.
To truly lower costs and premiums, we must inject competition, transparency, and personal responsibility back into the system. This means taking on the health care monopolies that profit from the status quo.
Insurers must be held accountable for practices like Medicare Advantage upcoding, which artificially inflates costs at the expense of the program's sustainability. Requiring insurers and providers to publicly post their prices would finally allow patients to see what they’re getting for the cost before they receive the bill—as they do for any other kind of purchase outside of health care. And American patients and taxpayers should no longer subsidize European drug price controls.
Hospitals, too, must be part of the solution. Hospitals routinely buy up physician practices and jack up rates for routine services that can be safely and effectively provided outside a hospital setting. Site-neutral payment reform would terminate that scam by equalizing Medicare payment rates regardless of where the service is provided—saving taxpayers $150 billion.
And government must do its part by stripping away the mandates and regulations that stifle innovation, instead building a landscape where transparency and competition are the primary drivers of value.
Rather than propping up the failed systems and government-planned markets Democrats created, we should empower Americans to become better informed consumers of their own health care. Health Savings Accounts put families in control of their health care dollars. We've already expanded HSA eligibility in the One Big Beautiful Bill, so its benefits are within the reach of more Americans. Now we should go further, making HSAs the foundation of a patient-centered system, not an afterthought.
The One Big Beautiful Bill was the first step to reverse Democrats’ cost of living crisis. Now we must finish the job. Through reconciliation 2.0, we can save our health care system and our nation’s balance sheet before we bankrupt the American people and our children’s future.
The choice is simple: we can either pretend things are working, when they are not; continue to point out the failures of Democrats’ government-run health system, while failing to do anything about it; or we can do what the American people expected us to do when they gave us unified Republican leadership: Make Health Care Affordable Again.
Jodey Arrington is the U.S. Representative for Texas’s 19th Congressional District and serves as the Chairman of the House Budget Committee.
