American families are paying nearly the price of a new car every year just for job-based family health insurance.
Then come the deductibles, copayments, prescription drugs, and medical bills that too often seem impossible to understand.
Healthcare is nearly one-fifth of the American economy. It affects affordability, wages, the federal budget, and ultimately whether Americans live healthier and longer lives.
That makes healthcare one of the most important issues in the 2026 election.
In the fifth and final episode of my How to Win 2026 series, I outline a Republican approach that begins with a simple idea: The healthcare system should work for the person, not the bureaucracy.
Republicans should offer Americans a clear, positive alternative that helps them pay less, gives them more choices, and creates a system focused on helping people live healthier, longer lives at lower cost and with greater convenience.
What Are Republicans For?
For more than 15 years, Republicans have allowed much of the healthcare debate to be defined by what we oppose.
We opposed Obamacare. We opposed government-run healthcare. We opposed Medicare for All. We opposed Washington bureaucrats making personal medical decisions.
Those objections were valid. But opposition is not a platform.
Americans have every right to ask Republicans: What are you for? How will I pay less? Can I keep my doctor? Will my insurance actually be useful when I need it?
Our answer should begin with four commitments:
Coverage that fits your needs, not Washington’s.
You choose the doctor, not the insurance company.
Lower out-of-pocket costs and more value from your coverage.
Protect Medicare and Medicaid by stopping fraud and helping extend the life of both programs.
Those are tangible benefits every American can understand. They also reveal the fundamental difference between the two parties.
Put the Person Back in Charge
The central problem with our current healthcare system is that the person it supposedly exists to serve often has the least information, the least power, and the fewest choices.
Government writes thousands of pages of rules. Insurance companies determine networks. Hospital systems add fees. Pharmacy benefit managers negotiate discounts patients may never see.
Republicans should not defend these institutions simply because they exist in the private sector.
We should hold insurance companies, hospital systems, and healthcare middlemen accountable when they hide prices, restrict choices, add unjustified fees, deny claims without explanation, or prevent savings from reaching patients.
The goal is not to replace one powerful bureaucracy with an even larger government bureaucracy. The goal is to empower the individual.
Lower Costs and More Choice
President Trump’s Great Healthcare Plan provides Republicans with a national framework for this effort.
It calls for lower prescription drug prices, lower insurance premiums, greater accountability for large insurance companies, and real prices patients can see. It also proposes directing health care assistance to eligible Americans rather than automatically sending it to large insurance companies.
Republicans are also working to expand access to coverage options that better fit people’s individual needs.
A healthy 28-year-old working in a restaurant does not necessarily need the same coverage as a family between jobs or a self-employed parent.
People have different budgets, risks, doctors, and needs. Every insurance plan should clearly explain what it covers, what it does not cover, and what a person may owe.
Then adults should be trusted to decide what provides the most value for themselves and their families.
Democrats trust the institution. Republicans should trust the person.
You Should Know the Price
Choice means very little if you cannot find out what something costs.
Before scheduled medical care, Americans should know three numbers: the total price, what their health plan will pay, and what they will owe.
Congress should pass legislation requiring real prices from hospitals, imaging centers, laboratories, and surgery centers.
Patients should also be able to see cash prices for services they can schedule in advance. Imagine going into virtually any other part of the American economy and agreeing to buy something without knowing what it costs.
We would consider that absurd. Yet in healthcare, we have allowed it to become normal.
Make Lower Drug Prices Reach the Patient
President Trump’s TrumpRx initiative represents an important break with the old system by giving Americans visible prices and a direct path to savings on important medicines. New federal data show prescription drug prices fell 3.1 percent over the last year, the largest annual decline since 1963.
But Republicans should go further. If someone can buy a covered medicine at a lower cash price, that payment should count toward his or her deductible and out-of-pocket limit.
If a pharmacy benefit manager negotiates a discount, the patient should see the benefit at the pharmacy counter.
The principle is simple. When the system saves money, the patient should benefit.
Protect Medicare and Medicaid by Stopping Fraud
Republicans should also be unapologetic about protecting Medicare and Medicaid from fraud and improper payments.
Verify that someone receiving a benefit remains eligible. Confirm that providers are real, qualified, and actually delivered the services they billed taxpayers for. Stop duplicate enrollments and payments to fake providers or deceased enrollees.
The Working Families Tax Cuts also closed a Medicaid financing loophole that rewarded higher prices throughout the system. HHS projects the reforms could lower prices outside Medicaid and generate substantial savings for families, employers, Medicare, and other payers.
Democrats routinely describe safeguards like these as cuts. That is exactly backward.
Every dollar sent to a criminal, fake provider, or someone who is not eligible is a dollar that cannot help a senior, a person with a disability, a low-income child, or a family in crisis.
Stopping fraud is not cutting care. It is protecting care.
From Healthcare to Health
The larger Republican opportunity goes far beyond making today’s healthcare system less expensive.
For most of the modern era, American health policy has focused on who pays the bill after somebody gets sick. That is important. But it is not the same as asking how we keep people healthy.
Insurance is not healthcare. And healthcare is not health.
If Republicans want to become the party of a healthier America, we should build a person-centered healthcare system focused on helping each individual live the longest, healthiest life possible.
We say person-centered rather than patient-centered for a reason. Hopefully, most of us spend relatively little of our lives as patients. We spend every minute as people.
Our health is shaped at home, at work, at school, at the grocery store, and through our daily habits long before we enter a doctor’s office.
We need to move from a sickcare system to a healthcare system.
Build a Person-Centered Health Care System
Imagine a system in which every American securely controls a complete lifelong health record.
Your medical history would not belong to a hospital, insurance company, or government bureaucracy. It would belong to you.
With your permission, technology and artificial intelligence could help organize that information, identify important changes, and help you and your doctor act earlier.
A better system would also bring medical innovation into care faster, reduce needless paperwork, strengthen local and rural healthcare, and measure success based on whether people are actually healthier rather than simply counting procedures, claims, and dollars spent.
The goal should be earlier action, better information, greater choice, and longer, healthier lives.
Our polling shows Americans already understand this. Eighty-one percent prefer a system focused on keeping people healthy instead of primarily treating them after they become sick, and 97 percent say finding health problems earlier is important.
Two Health Care Futures
This brings us back to the central argument of How to Win 2026.
The election should be a choice between two teams and two futures.
The Democratic future in healthcare means more centralized decisions, more Washington-designed insurance, and more power for bureaucracies.
The Republican future should begin with tangible benefits:
Pay less.
Have more choices.
Choose your doctor.
Know the price.
Get more value from your insurance.
Protect Medicare and Medicaid from fraud.
Hold powerful institutions accountable.
And then build something larger: a person-centered healthcare system designed around each individual’s long-term health.
Government has important responsibilities. It should fight fraud, enforce honest disclosure, help people who genuinely need assistance, support basic science and public health, and prevent powerful institutions from trapping patients.
But government should serve the person. The person should not serve the system.
A Healthier America
Republicans have an opportunity to make healthcare part of our affordability agenda, our innovation agenda, and our vision for America’s future.
We can help Americans pay less and get greater value today while building a healthcare system that helps families live healthier, longer lives tomorrow.
That is a positive Republican healthcare agenda.
And that is how the Republican Party can become the party of a healthier America.
Listen to the fifth and final episode of How to Win 2026:
The Republican Opportunity
How to Win 2026 is part of a larger effort to identify the ideas, policies, and arguments that can create a lasting American majority.
Explore our latest columns, research, commentary, and analysis on the Republican Opportunity in 2026.
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