2026 Healthcare Agenda

Finance: The President’s 2026 Health Care Agenda, September 4, 2025

I. Vaccines

There are two aspects to vaccination policy that must be considered: those which represent the best scientific knowledge and those that represent values held by American citizens. The election of President Trump came with the promise, which was kept, to appoint the Secretary - in part to implement certain values regarding individual autonomy. 

The Secretary’s personal views on the relationship between vaccines and any complications are not his call as the political leader of the Department. The extent to which the statute creating and authorizing the Department vests decision authority in the Secretary is not the fault of Mr. Kennedy - it is the fault of the Congress. To those who believe in a unitary executive, the status quo is a feature, rather than a flaw. Recent experience, as well as the views of members of the Committee on both sides of the aisle show that this belief is misplaced. 

At some point in the future, possibly as early as 2027, a firewall preventing partisan interference with scientific decision making must be put in place - either by enacting professional requirements for departmental leadership or for certain components within it. While partisan political leadership is essential to our system of governance, like the First Amendment, it should not be a suicide pact.

As important is the fact that the presidency is not the only method by which the American people put their values into the law. It was not designed for that purpose. Rather, it is the Congress of the United States who has the obligation to bring our nation’s values into public policy. Like any American, the President can certainly share his views with Congress, but such views cannot be allowed to override them, lest single party tyranny put the views of some Americans over the views of the rest. 

Note that in our correspondence with the Committee regarding the Secretary’s confirmation, we registered our support. This was not an endorsement of his views on vaccinations, but to further his agenda into the health effects of the American diet, especially with regard to ending the marketing of high fructose corn syrup as a healthy substitute for natural fats. While food additives that may be carcinogenic have gotten Secretary Kennedy’s attention recently, the affect the diet food industry has had in creating our crisis of obesity, diabetes, heart attack, stroke and dementia is more important - regardless of the interests of farmers in producing it.

II. Health care reform

We have included modified comments on lowering health care costs first submitted in September of last year, as well as our option paper on health insurance reform delivered with our comments on the FY22 HHS budget testimony to this committee - both of which highlight the use of a Public Option for those who cannot afford the plans offered by health insurance exchanges. We now offer the following new observations on health care reform. Please share these Secretary Kennedy, as your contact list is better than mine.

The concept of a Public Option came from the health care reform enacted by then Massachusetts Governor, now Utah Senator, Mitt Romney.  

The Romney public option provisions are superior to the combination of catastrophic insurance and health savings accounts (possibly including tax free flexible spending accounts) associated with Senator Dole in opposition to President Clinton’s reforms. The Dole proposals were so unpopular that they were not offered by Republican members as an alternative to the Affordable Care and Patient Protection Act, even though they would have been the most effective means of lowering health care costs.

This approach was supported by the Center for Fiscal Equity - provided that flexible spending accounts could also be used as a line of credit that would not expire from year to year - and with credit v. saving account percentages tailored to meet the economic demands of each family - in other words, that they be means tested - with very poor households receiving a much higher HSA and no requirement to purchase a flexible spending plan to offset catastrophic expenses.

We now support the Romney version of the public option. His version of the proposal should be studied by the Department and brought forward as soon as possible by the Administration for enactment before the 2028 election.

We must note that the Affordable Care Act could only be passed by baseline manipulation adding all student borrowing to the Department of Education, taking it from the private sector. As a consequence, student loan borrower difficulties were magnified - which led the Biden Administration to repair the damage to student borrowers by forgiving packets of student loans held by the government.

The Act must be repealed, in parts, to

1. Lower premiums and eliminate co-pays for the individual plan.
2. Replace Medicaid for non-retirees with a subsidized Public Option.
3. Abandon funding through a tax on investment income over $400,000, replacing it with either a subtraction value added tax paid by employers - with partial offsets for any coverage provided to employees and retirees - or by enactment of a national goods and services (value added) tax (GST) or a stable general tariff adequate to replace the current subsidy for health insurance coverage; full funding of Medicare - including that portion of Medicaid paid to the disabled and retirees so that the states can be relieved of this obligation; and to fully fund the public option.
4. Replace employer-paid contributions to Social Security with the GST or tariff and credit  each worker the same dollar amount rather than an amount matching their contribution, which makes the eventual establishment of personal retirement accounts possible without damaging the redistributional aspects of the program.
5. Replace pre-existing condition reforms with universal enrollment of those denied coverage due to such conditions with automatic enrollment in the Public Option.

Attachment: Lower Healthcare Costs for Americans

Attachment: HHS Budget, FY22