Republicans should not immediately capitulate and agree to throw more taxpayer money at a failed government program. Consumers have the power to improve the cost and quality of health care in America.
| Opinion contributor
2025 government shutdown hits 36 days, longest in US history
The 2025 shutdown hits 36 days during President Donald Trump’s second term, breaking records as lawmakers clash over health care and tax credits.
The cost of Obamacare has become so burdensome that families making up to $600,000 a year qualify for thousands of dollars in enhanced taxpayer-funded subsidies. I think the average American would be enraged to know their tax dollars are going toward health care for rich people.
It’s not just bad policy; it’s nonsensical. Democrats don’t care if it makes sense as long as they can preserve this lucrative arrangement for large health insurance companies and their wealthy supporters. They want to keep these subsidies for rich people so badly that they literally shut the government down over it.
Republican leaders insist they will not submit to the Democrats’ demands that taxpayer subsidies prop up the crumbling edifice of Obamacare under the duress of a government shutdown.
But, at some point, the government will reopen, and congressional Republicans should not immediately capitulate and agree to throw more taxpayer money at a failed government program. Republicans should embrace free market reforms to dissolve the chains of regulation that needlessly make health care more expensive.
There’s a better marketplace option for health care than Obamacare
My plan – the Health Marketplace for All Act – would make health care more affordable by allowing individuals to join together to collectively bargain and improve their leverage to negotiate lower health care premiums from insurers. Leaders from both major parties should agree that the empowerment of consumers, not mandates and subsidies, will improve the cost and quality of health care in America.
My plan would make it legal for businesses such as Costco, Sam’s Club and Amazon to offer group health insurance to their members. If Costco’s tens of millions of members purchased insurance as a group, they would have the leverage of size to force premiums lower.
Nearly 20 years ago, President Barack Obama promised the American people that Obamacare would reduce health care premiums by up to $2,500 annually.
Unfortunately, we have continued to see costs rise so that the average employer-sponsored health insurance premium is now just under $27,000 a year. Providing health insurance to employees should not cost as much as a new car.
Republicans must fight back against an Obamacare bailout
Republicans must reject a $400 billion Obamacare bailout. Instead, Congress should empower groups and employers to provide high-quality health benefits at affordable prices.
Obamacare destroyed the individual health insurance market with onerous regulations, so we must radically expand the ability of individuals to join together to purchase health insurance as employers under the Employee Retirement Income Security Act.
One of the major reasons why many Americans do not have access to affordable health insurance is that they do not work for a large corporation. A sole proprietorship or a small business has little leverage against big insurance, and if someone gets very sick, the group does not have the protection of hundreds or even thousands of people sharing the risk.
My Health Marketplace for All Act would allow any group of people to join together to provide health insurance to its members, regardless of employment relationship, giving a large boost of leverage to an otherwise small group of health insurance customers. It would empower them to form a much larger unit and collectively bargain with health insurers for better rates.
Large corporations have greater negotiation power with insurance companies and have access to a wide array of benefit advisers and consultants that small businesses simply cannot afford. They also benefit from massive economies of scale that make the large administrative costs in health benefits more efficient.
Small businesses are at a significant competitive disadvantage when most Americans who don’t receive health care from the government expect their employer to provide it. Small insurers are often unable to self-insure and pay for all claims with their own revenues, a key tool for controlling health care costs that large companies utilize.
Small businesses are then forced to buy expensive, fully insured plans from carriers like Blue Cross, United, Cigna and Aetna, or move employees over to Obamacare and Medicaid.
Imagine your Costco or Amazon membership giving you access to health care
Instead of shifting more health care costs to the taxpayer, we can make it easier for workers to use their freedom of association to get higher-quality health care. The government should not stand in the way of market-based incentives to lower the cost of health insurance.
Imagine membership-based services like Costco memberships and Amazon Prime subscriptions giving you the ability to access high-quality health care as well.
It is not just businesses that could take advantage of my Health Marketplace for All Act. Churches, credit unions and nonprofit associations like Scouting America could become new sources of health coverage that would not cost taxpayers anything. Associations could compete against one another to provide the best possible price for their members. The days of losing your health insurance when you get sick and lose your job could be long gone.
Our current health care system does not operate in a free market: No one knows the price of a health care good or service until they get the bill. With regard to health care, the free-market incentives to reduce spending and increase quality have been crushed by government regulation and mandates. We cannot expect only employers to save us from more socialized medicine. They need help, and bestowing groups of individuals with some of the same privileges we give employers is a commonsense attempt to fix the problem.
Republicans should oppose any Obamacare deal that gives more subsidies directly to wealthy Americans and insurance companies without fixing the root causes of the dysfunction in the health care system. Democrats want to reopen the government without reforming their broken health care system.
The Health Marketplace for All Act is the free market alternative Congress should consider to make health insurance more affordable.
Rand Paul is a United States senator from Kentucky.
