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Subsidizing insurance props up dysfunction. There's a better path.

Los Angeles Times

|

November 20, 2025

Directing payments to consumers would incentivize them to curb healthcare spending using leverage with providers

- KIM-LIEN NGUYEN GUEST CONTRIBUTOR

CONGRESS ENDED its impasse to reopen the government, but the Democrats' reason for the shutdown remains unresolved: the renewal of expiring subsidies for insurance premiums under the Affordable Care Act.

Republicans offered an olive branch to end the standoff by proposing to make payments into Americans' health savings accounts or flexible spending accounts. Although this idea was not realized, the proposal should not be forgotten as the parties work on compromises for long-term government appropriations. The Republicans' plan would allow individuals to choose between putting the money toward insurance premiums or spending it directly on healthcare. This offers a refreshing change from the top-down approach to healthcare that has dominated both political parties for generations.

Moving away from insurance subsidies and directing payments to taxpayers would serve as a first step toward empowering Americans to make their own healthcare choices and leverage their self-interest to contain healthcare costs. Americans would be incentivized to curb spending and would have the upper hand in bargaining for lower costs with providers. This approach offers a path for opening up access to healthcare while addressing the underlying problem plaguing our system: healthcare inflation.

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