Republicans have a generational opportunity to fix what Barack Obama broke
With Republicans in control, the time has finally come to offer practical health care solutions to drive down costs and improve care. It can be done with a single, clean bill that the majority of Americans will celebrate and Democrats will struggle to justify opposing. The plan doesn’t require a single vote to repeal the Affordable Care Act, because the plan will simply bypass it.
Here are the straightforward provisions that will right what President Barack Obama got wrong. Republicans should send it to the president’s desk as soon as possible.
1. Catastrophic Plans Across State Lines (Effective Jan. 1, 2026)
Bring back the popular catastrophic-only insurance plans that Obamacare made illegal. Starting next year, any licensed insurer may sell such plans nationwide. No mandated benefits, no strings attached. Allow insurers to underwrite, give them the option to price for pre-existing conditions and offer any deductible they choose. This will provide many Americans with the low-premium, high-deductible coverage they demand.
SENATE REPUBLICANS LAND ON OBAMACARE FIX, TEE UP DUELING VOTE WITH DEMS
2. Universal HSA Eligibility and Higher Contribution Limits (Effective Jan. 1, 2027)
Health Savings Accounts (HSA) should be for everyone. Every American — whether on a catastrophic plan, an employer plan, a Medicare Advantage plan or even traditional Medicare — becomes eligible for a tax-free HSA. Contribution limits rise to the levels recommended in the Senate’s most recent reconciliation package (roughly $8,000 individual/$16,000 family, indexed for inflation). Stoke these accounts with some tariff revenue. Millions of families will have a powerful, portable tool to control costs for decades to come.
3. State High-Risk Pools and Mental Health Block Grants
Everyone wants to help take care of those most in need, but we need to do so more efficiently. Matching federal seed money (capped per state) will help participating states stand up or expand high-risk pools and mental-health programs. Citizenship verification will, of course, be required. Let the 50 states experiment and discover what actually works instead of letting Washington pretend it has all the answers.
4. Price Transparency and Cash Pricing
Every provider must post cash prices and offer every patient — insured or uninsured — a transparent cash option at the time of scheduling. "We can run this through insurance for $1,400, or you can pay cash today for $400." Sunlight is still the best disinfectant.
5. End Unlimited Tax-Exempt Status for Mega-Hospitals
Cap the tax-exempt revenue threshold for nonprofit health systems at $5 billion. Giant "nonprofit" hospital chains that behave like government monopolies don’t need excessive handouts. Ever notice the multibillion-dollar health care systems have the biggest, nicest buildings in town and always seem to be under new construction? There is a place for nonprofits, but at some point, enough is enough with government subsidies.
6. Emergency Care Is Provided, but It Is Billed
The government must end federal subsidies for emergency room care. If states want to subsidize uncompensated ER visits, they are free to do so with their own dollars.
7. True Association Health Plans and Purchasing Pools
Any group — trade associations, churches, alumni groups, even Costco’s 40 million members — can band together across state lines to negotiate rates with insurers and providers. Bigger pools mean better prices. This is the free-market answer to "If you like your union plan, you can keep it."
8. One-Year Subsidy Extension
Extend the current enhanced ACA subsidies through Dec. 31, 2026. By giving families certainty and preventing immediate loss of coverage, Republicans buy time for these real solutions to take effect. But they also give every Democrat a reason to vote for the bill by keeping those subsidies for one more year. The reality is Americans can’t afford to get slammed with thousands more in premiums, but the country can’t afford to keep subsidizing outrageously expensive health insurance premiums. Offer a compromise of a one-year extension in exchange for the points above to take effect.
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This eight-section bill is short enough to read on the House floor in 20 minutes. It delivers lower premiums right away (catastrophic plans), permanent consumer power (HSAs for every American), and real protection for the truly sick (state high-risk pools). It ends the most egregious hospital monopolies, forces price transparency and stops the abuse of "free" emergency rooms.
Most importantly, it is politically bulletproof. Democrats would have to vote against extending subsidies, against lower premiums for young people, against HSAs, against price transparency and against helping the chronically ill — all in one vote. Good luck explaining that in the 2026 midterms.
Republicans spent years saying they had a better plan than Obamacare. This is it. It’s simple, it’s popular and it’s ready. Pass it now, sign it before New Year’s, and let Americans see what real healthcare choice looks like.
The clock is ticking. Pass a bill. Deliver on the promises. The American people have waited long enough.