Ever since the Big Beautiful Bill passed the House, the Left has been critical of healthcare provisions in the legislation. As in prior debates about this issue going back 25 years, the complaints are the same old tired arguments with different numbers.
The bill proposes $800 billion in Medicaid cuts, which could lead to 7.8 million people losing coverage by 2034. Rural hospitals, which rely heavily on Medicaid reimbursements, are at high risk of closure. As more uninsured patients seek emergency treatment, hospitals will face an estimated $42 billion in additional uncompensated care costs by 2034. For example, Medicaid reimbursements for mental health, maternity care, and emergency services would be reduced, forcing hospitals to cut services. The bill requires most working-age Medicaid recipients to prove they are employed, studying, or volunteering to retain coverage. It fails to extend enhanced premium tax credits, which could result in 4.2 million people losing Obamacare coverage. Further, the bill limits state-directed Medicaid payments and bans new provider taxes, reducing hospital funding.
While many of these points are true, the sad fact is that the United States can no longer afford to provide generous medical benefits to everyone. Our debt burdens are so significant, and annual deficits so high, that unless we curtail costs across the board, we could face a dire fiscal situation from which there is no escape.
If the Senate doesn’t step in with meaningful reforms, this Bill could exacerbate healthcare costs, leaving Americans struggling even more with an already broken system. In fact, the Senate can pass relatively modest amendments to lower overall healthcare costs and improve the quality of care. The two fronts they can tackle are hospital pricing transparency and skyrocketing insurance deductibles.
Imagine walking into a grocery store where the price tags are hidden, and you're told you'll receive a bill weeks later—but only after the store has negotiated a secret price with your credit card company. This absurd scenario is exactly how hospital billing works, and it remains one of the most significant financial risks for American families.
Despite federal laws requiring price transparency, the overwhelming majority of hospitals either fail to comply or post intentionally confusing data. A 2024 study found that more than half of U.S. hospitals do not provide full-price disclosure, leaving patients guessing about costs until after they've received treatment.
This lack of transparency allows hospitals and insurers to set arbitrary prices, leading to the massive discrepancies Americans see in healthcare costs. A routine MRI might cost $600 at one hospital and $2,500 at another—with no meaningful difference in quality or service. If patients had clear access to pricing upfront, they could compare costs and make informed decisions rather than being blindsided by excessive fees. In many cases, a cash-paying patient will likely pay hundreds of dollars less than “negotiated discount prices” between insurance companies and providers.
The Senate should mandate upfront cost disclosures that patients can access before receiving treatment—just as they would in any other industry. It should insert language to force hospital compliance with existing transparency laws and impose real penalties for facilities that fail to provide easy-to-understand, accessible pricing. Penalties could include the suspension of Medicare and Medicaid reimbursements.
On the deductibles front, many Americans now pay amounts exceeding $5,000 per year, meaning they must incur thousands in out-of-pocket expenses before their insurance provides a single dollar of coverage. This system makes preventive care prohibitively expensive, leading to delayed treatments, worsening health conditions, and, ultimately, higher emergency costs. Even worse, employers continue shifting costs onto workers, raising deductibles under the guise of reducing monthly premiums. Meanwhile, insurance companies report record-breaking profits, reinforcing the failure of private insurers to prioritize patient well-being over financial gain.
The Senate must impose protections against excessive deductibles by capping deductibles for employer-sponsored and marketplace insurance plans to prevent policyholders from facing massive out-of-pocket expenses before coverage begins. For those who complain that we are advocating price controls, we would like to respond that America's healthcare costs have continued to rise with no meaningful improvement in the quality of delivery. Since 2000, healthcare costs—including services, insurance, and prescription drugs—have risen by 121.3%, while general consumer prices increased by 86.1% in the same period.
A nice bonus to have would be eliminating surprise medical billing. Many Americans believe their insurance will fully cover a hospital visit, only to receive unexpected charges months later—including facility fees, out-of-network provider costs, and inflated emergency room bills. These billing practices disproportionately affect lower-income patients, leaving them with medical debts they cannot predict or avoid. Even insured individuals find themselves in financial crises simply because their hospital failed to disclose hidden fees.
The One Big Beautiful Bill Act has the potential to be transformational—but not if lawmakers continue ignoring the most significant healthcare affordability issues facing Americans today. The Senate must step up by demanding price transparency enforcement, deductible protections, and an end to surprise billing.
Healthcare should be accessible, affordable, and transparent—not a financial trap that forces Americans into lifelong debt for basic medical care. The Senate has a critical opportunity to fix these flaws before the bill becomes law. If it does not take action, it will have failed the American people in one of the most pressing crises of our time.
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