The problem: Healthcare costs are high. Many Americans can’t afford even basic healthcare.

The simple, affordable solution: Recognize that the U.S. government is Monetarily Sovereign, meaning it never can run out of dollars to cover its expenses.

Also recognize that federal spending creates economic growth and costs taxpayers nothing.

With this understanding, we should implement comprehensive, no-deductible Medicare for all Americans, regardless of age, income, or pre-existing health conditions.

We already know how to navigate the difficult task called “Medicare.” Expanding coverage to the entire nation is a straightforward step that requires money — of which the federal government has an endless supply.

It’s simple and affordable.

The government’s complex, unaffordable non-solution is described in the following article:

Premium Reports from Epoch Times Spiraling Costs and a Broken Insurance Market—What Went Wrong With Obamacare   By Lawrence Wilson, November 23, 2025

The government shutdown might be over, but the political and financial problems that dog Obamacare haven’t gone away.

Congress is now debating a second extension of the temporary tax credits that have shielded Obamacare users from rising costs for five years.

Without the subsidies, Democrats say millions of Americans will be priced out of the health insurance market at the stroke of midnight on New Year’s Eve.

President Donald Trump and other Republicans don’t want an extension; they want a transformational change that eliminates what they say are the unworkable policies and perverse incentives that have plagued the program from the beginning.

The policies are unworkable because the Republicans and the Democrats don’t really want a solution. The Republicans don’t want to help the poor. The Democrats want to help the poor, but are afraid to spend what’s required to help all the people.

The Republicans will not come up with a “transformational change” unless it transforms something that is worse for the poor and better for the rich.

(As an aside, Stephanie Kelton once was an advisor to the Democratic Party, and probably told them the government could afford to spend the money, though even she had unfounded worries about inflation.)

It isn’t just Republicans who say Obamacare went awry. Many experts and even some Democrats recognize that while the program did make health coverage more affordable for 24 million Americans at one point, it has essentially backfired.

It could and should be free to all Americans.

Here’s how they think Obamacare went off course, how it might be overhauled, and how it upended the wider health insurance market.

Failed Aims The Affordable Care Act aimed to make health insurance affordable for everyone and lower health care costs across the board.

“The reality of the [Affordable Care Act] could not be more different,” Douglas Holtz-Eakin, president of the think tank American Action Forum, said in written comments to a Senate committee on Nov. 19.

Republicans have said the system was poorly designed from its beginning in 2014. Now, some Democrats agree it has not been successful.

Keep in mind that the Republicans have been saying this from the beginning, yet in all that time, they never have come up with a “well-designed” program. It comes down to one truth: The party of the rich does not want to help the poor. Period.

Sen. Peter Welch (D-Vt.) said as much in a Nov. 6 speech imploring colleagues to extend the temporary tax credits, which expire in December.

“I owe you an answer on why it is I am standing here today asking to extend something that was temporary,” Welch said. “Here is the reason: We did fail to bring down the cost of health care.”

Sen. Bill Cassidy (R-La.) said on Nov. 19: “I think there’s remarkable agreement between Democrats and Republicans. Obamacare failed to give access to all Americans to health care, and Obamacare failed to control health care costs.”

The Republican “solution” is to give access to as few as possible.

When Obamacare was proposed, the Congressional Budget Office projected that enrollment would reach 29 million by 2019 and that the percentage of uninsured adults would drop from 17 percent to 6 percent.

That didn’t happen. By 2019, enrollment had plateaued at around 11.4 million, and about 11 percent of adults remained uninsured.

The reason: It cost too much. Healthcare for all Americans should be free. (Unless the politicians are satisfied with the poor using the hospital emergency room as their free, all-purpose, healthcare facility.)

A year later, Congress altered the program in 2020 to help Americans cope with the economic downturn caused by the COVID-19 state of emergency.

The key change was the addition of “enhanced” tax credits that made middle-income households eligible for subsidized health care and allowed some low-income households to get coverage with a zero-dollar premium.

This should have been done for all Americans, not only because of COVID, but because the federal government’s purpose is to protect and improve the lives of all the people, not just the wealthy.

The enhanced credits were offered for two years, beginning in 2021, then extended through 2025.

Enrollment skyrocketed, doubling in five years. But the cost was climbing rapidly, too.

Even before the enhanced tax credits came online, premiums had more than doubled since 2013, the year before Obamacare began. By 2025, the increase reached nearly 133 percent, about four times the rate of inflation.

Health care costs generally rose dramatically in that decade, partly because of rising wages, consolidation within the industry, an aging population, and the popularity of new and expensive medications, according to the Committee for a Responsible Federal Budget.

Meanwhile, some analysts say Obamacare is the key driver of higher premiums.

The premiums should be, and easily could be, $0.00.

Market Disruption With traditional health insurance (and other forms of insurance), the price to the customer is based on the risk to the

Obamacare is different, however. insurer and the type of coverage they choose.

A key selling point of Obamacare was that it largely ended the practice of excluding people from health coverage due to preexisting conditions. No one would be denied coverage due to illness, and all plans were required to offer the same set of minimum benefits.

That is an excellent program.

As this one-size-fits-all system treats high- and low-risk customers the same, many younger, healthier people left the market, leading to higher premiums.

Healthier people would not leave the market if premiums were free.

And because preexisting conditions are not a barrier to coverage, those consumers enter the market only when they become ill, raising costs even higher, Sen. Ron Johnson (R-Wis.) told The Epoch Times.

Again, this would not happen if premiums were free.

Those increases spread across the industry because the Affordable Care Act requires insurers to offer Obamacare compliant policies to individuals and small groups in the commercial market.

The solution, Johnson said, is to cover those with existing illnesses in high-risk pools, which allow groups of people within Obamacare to be priced and subsidized separately.

The Johnson so-called “solution” is high-risk pools, which will change unaffordable premiums — a perfect right-wing approach.

“You have to reestablish those,” Johnson said. “You have to start by covering people with preexisting conditions.

“You bring as much free market back into health care as possible, so people are actually competing for customers with price, customer service, and quality.”

Johnson doesn’t say how high-risk pools would make insurance companies compete for customers without raising prices sky high.

A Spiral Masked by Subsidies Gross federal subsidies of Obamacare now stand at an estimated $138 billion per year, according to the Committee for a Responsible Federal Budget.

Those subsidies have masked the rise in premiums, allowing them to rise virtually unchecked, according to Brian Blase, founder of think tank Paragon Health Institute.

The subsidies have not “masked” anything. They have paid premiums that otherwise would be unaffordable.

“When enrollees pay only a small slice of the premium or no premium at all, insurers face almost no price discipline,” Blase told Senators on Nov. 19.

Blaise’s “price discipline” does not exist. The consumer simply does without, sickens, and dies.

By 2024, 80 percent of Obamacare customers qualified for plans costing them no more than $10 per month, according to the Treasury Department.

A better rate would be $0.00 a month, a rate the government could absorb without collecting a penny in taxes

That created a spiral that kept pushing the cost up, Blase said. “Higher premiums created pressure for still more subsidies. More subsidies lock in a high-cost system and permit large insurers and hospital systems to remain inefficient.”

Someone please ask Johnson and Blaise why their theories don’t seem to apply to Medicare, where preexisting illnesses are covered and there is little evidence of a cost spiral.

That rising premiums also drove out general market consumers who did not qualify for a subsidy, causing even further increases, said Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services.

That wouldn’t happen if the federal government paid all the premiums as it now does with Medicare.

The Obamacare market was designed for a 50/50 mix of private-sector customers, and those who need financial help, Oz said in a Nov. 16 interview with CNN.

“We have priced the systems now so heavily with government subsidies that it crowds out the private shopper,” Oz said.

So instead, Oz wants to crowd out the poor, leaving them no alternative but the emergency room, thus shifting the price burden from the government (which can afford anything) to hospitals, which must raise prices to the private-sector customers. See the irony?

Perverse Incentives in the Workplace Large employers, those with more than 50 employees, face a $2,900 fine for each full-time worker who receives an Obamacare subsidy. That’s to encourage companies to offer employer-sponsored health insurance.

Who pays when the companies offer employer-sponsored health insurance? Only two groups: Consumers and employees. In short, the private sector pays for health care rather than the federal government, which has limitless dollars.

In reality, it may have the opposite effect for employees earning below a certain level, according to Holtz-Eakin.

“You could do the math and figure out that … it made a lot of sense for employers to just stop being in the insurance business, put their workers in the exchanges, and both the worker and the employer could come out ahead,” Holtz-Eakin said.

And this supposedly is a bad thing — for workers and employers to come out ahead. Isn’t that exactly what Obamacare was designed to do?

That appears to have happened in many smaller companies, which have no threat of a fine to induce them to buy insurance for employees.

The year before Obamacare began, 85 percent of companies with 25 to 49 workers offered health insurance for their employees. By 2025, that had fallen to 64 percent.

Ripe for Fraud When the enhanced tax credits were introduced in 2021, 42 percent of the uninsured population qualified for a policy with a zero-dollar premium. To boost and maintain enrollment during the health emergency, eligibility checks were relaxed, and reenrollment was automated.

Also, insurance brokers receive a commission for each person they enroll.

Those factors made the program ripe for fraud and abuse, Blase said.

Offering free health care insurance would eliminate eligibiity check and brokers commissions, two unnecessary expenses.

“Many enrollees were signed up without their knowledge or consent,” Blase said. He noted that some unscrupulous vendors promised enrollees cash benefits, and others were moved from one plan to another without their consent.

Approximately 2.8 million people were dually enrolled in Medicaid or the Children’s Health Insurance Program in multiple states in 2024, or simultaneously enrolled in one of those programs and an Obamacare plan, according to federal data.

Also, 40 percent of those enrolled in a zero-premium plan in 2024, more than 4 million people, filed no medical claims.

All those problems would disappear with a Medicare-for-All, single-payer plan.

The national average for zero-claim health insurance customers is 15 percent, according to Paragon Health Institute, which estimates that taxpayers spent $35 billion in 2024 to insure people who were unaware they had coverage.

Isn’t that exactly how insurance is supposed to work? That’s why it’s called “insurance,” not salary.

While Democrats acknowledge that rising health care costs are a problem, they say it’s not related to Obamacare. Proposed solutions generally involve increasing corporate taxes and cracking down on corporate abuses.

Or better yet, single payer health care that covers everyone.

“Insurance premiums are skyrocketing,” Rep. Jonathan Jackson (D-Ill.) told The Epoch Times on Nov. 20. He named government negotiations on drug prices and higher corporate taxes as partial solutions.

Both of those “solutions” take growth dollars out of the economy and give them to the federal government, which has no use for them.

Sen. Ron Wyden (D-Ore.) said on Nov. 19 that reducing health care costs “means reining in insurance company abuses across the health care system.”

Ever since the politicians learned the word “abuse,” they have described anything that benefits the economy, especially what benefits the poor, as abuse. You seldom hear them call tax loopholes for the rich, “abuse.”

Republicans generally favor market-based reforms that give consumers more control over their health care spending.

“More control” is a right-wing synonym for: “The poor pay.”

“The free market guarantees three things,” Johnson said. “The lowest possible price and cost, the best possible quality, and the best level of customer service.”

The free market guarantees that the wealthy will pay less and the poor will pay more. Isn’t that why we have anti-trust laws?

Trump has proposed a direct cash payment to low- and middle-income Americans to be used for health care expenses. Cassidy and Sen. Rick Scott (R-Fla.) have proposed similar ideas.

Yes, Republicans Trump, Cassidy, and Scott want to give people $2,000 a year. How generous. Here is what ChatGPT’s massive information sources say about healthcare insurance costs:

Average Annual Health Insurance Cost in the U.S.

1. Employer-Sponsored Insurance (2024)
   • Average annual premium for single coverage: $8,951
   • Average annual premium for family coverage: $25,572
   • On average, workers contribute: $6,296/year toward family coverage.
2. Affordable Care Act (ACA) / Marketplace Plans
   • According to Insurify, the average annual premium for a single person on a mid-level (marketplace) plan is $5,964.
   • Forbes Advisor estimates that for ACA marketplace plans (before accounting for subsidies), the average premium is about $590/month → ~$7,080/year.
   • According to Fidelity, a 40-year-old on a typical Silver ACA plan would pay around $497/month → ~$5,964/year.
3. Other Data
   • MoneyGeek reports that, on average, health insurance costs $599/month for an adult on a marketplace plan → ~$7,188/year.

Oh, those Republicans are so clever. They’ll give you $2,000 and cost you $6,000 to $26,000 or more. Be sure to give them your vote.

Rep. Chip Roy (R-Texas) named direct primary care, health sharing ministries, and expanded Health Savings Accounts as ways to empower patients to make their own health decisions.

“Empower” is another current right-wing synonym for “charge.”

“I want to free up individuals to have better options,” Roy told The Epoch Times. “If you’re starting there, then you’re going to be transformative, and that will drive prices down,” Roy said.

Yes, more right-wing synonyms. “Free up” means “cost.” “Better options” means “unaffordable options.”

Congress is expected to vote in mid-December on an extension of enhanced subsidies and possibly other health care reforms.

No matter what happens, so long as the current right wing has voting power, the middle- and lower-income will be screwed, and the rich will do just fine, thank you.    

Rodger Malcolm Mitchell

Monetary Sovereignty

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A Government’s Sole Purpose is to Improve and Protect The People’s Lives.

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