Healthcare

HEALTHCARE

MPA supports widespread healthcare access without unnecessarily placing the entire system under government control.

Priorities include:

• Patient choice

• Provider competition

• Price transparency

• Insurance portability

• Prescription-drug competition

• Generic and biosimilar competition

• Expanded provider capacity

• Mental-health capacity

• Emergency treatment

• Reduced bureaucracy

• Protection of the physician-patient relationship

Healthcare policy should focus heavily on why healthcare costs so much, rather than endlessly debating only who pays the inflated price.

WHY THIS MATTERS

America spends heavily on healthcare while patients often cannot learn the price, compare providers, obtain timely care, or understand a bill. Reform must lower the underlying cost, expand capacity, preserve choice, and protect people from catastrophic loss.

WHAT MPA WILL DO

• Require hospitals, insurers, laboratories, pharmacies, and other major providers to give usable advance prices and patient-specific out-of-pocket estimates for scheduled care.

• Enforce competition law against anticompetitive hospital, insurer, pharmacy-benefit-manager, and medical-practice consolidation; prohibit contract terms that hide prices or block lower-cost competitors.

• Use site-neutral payment for clinically equivalent services, with limited transition support where access would otherwise be lost.

• Accelerate safe generic and biosimilar competition, prevent abusive patent extension, disclose pharmacy-benefit-manager compensation, and pass negotiated savings to patients and plan sponsors.

• Expand provider capacity through interstate portability and scope-of-practice reform tied to verified training and quality standards.

• Require simple, standardized bills, prompt claim decisions, independent appeals, and protection from surprise out-of-network charges beyond a patient's control.

• Publish the cost, funding source, access effect, and measurable outcome of every major healthcare subsidy or mandate.

MEDICARE, MEDICAID & PRIVATE COVERAGE STRUCTURE

Medicare at Age 70

Medicare eligibility begins at age 70. Qualifying covered care for an eligible person is publicly covered without an ordinary premium or point-of-service charge. Medicare may not pay more than the lowest verified comparable net price paid by a private purchaser for the same service, drug, device, quality, location, and clinical circumstances. Medicare retains a lower price when its existing rate is already below the private comparison.

Medicaid for Poverty or Disability Through Age 69

Medicaid covers people age 69 or younger only when they qualify because of poverty or disability. States administer the program under a federal minimum standard of medically necessary care, timely access, due process, financial integrity, and nationwide portability. A person moving between states may not lose necessary care merely because records or responsibility are transferring.

Income determines how much a recipient can reasonably contribute. The nature, severity, permanence, and functional effect of a disability may reduce or eliminate the contribution. No required payment may deny medically necessary care that the person cannot afford.

Medical Eligibility and Independent Review

Disability-based eligibility is determined by qualified medical review and independently audited. The review schedule must fit the condition:

• every six months for a condition reasonably expected to improve quickly;

• annually or at a longer evidence-based interval for a condition that may change;

• no repeated medical review for a permanent condition when competent evidence shows that improvement is not reasonably expected.

A reviewer may not deny care solely to meet a budget target. The person receives the evidence, a written reason, time to respond, continuity of necessary treatment during a timely appeal, and independent review of a disputed decision.

Private Coverage for Everyone Else

A person who is not eligible for Medicare or Medicaid obtains private healthcare coverage through an employer, a voluntary association, or direct individual purchase. Employers may offer private health coverage but are not required to operate a health plan. The government should enforce transparent contracts, competition, portability, truthful pricing, and protection against fraud while preserving a person's ability to choose and purchase lawful coverage.

No Public Overpayment

Medicare and Medicaid purchases must use the same anti-overpayment rule as every other federal program. Drug rebates, insurer discounts, hospital concessions, pharmacy-benefit-manager payments, facility fees, and related-party arrangements must be included when identifying the actual net comparable price.

Core MPA standard: Protect seniors, poor people, and people with disabilities. Use private coverage for everyone else. Pay a fair verified price for the same care, and never mistake a higher private price for a required public price.

WHAT MPA WILL MEASURE

Premiums and out-of-pocket costs; price-estimate accuracy; claim and appeal times; avoidable emergency use; appointment wait times; rural access; provider and insurer concentration; generic and biosimilar uptake; psychiatric bed and crisis capacity; patient outcomes; and medical debt.

Related policies: Mental Health & Psychiatric Care; Senior Health, Guardianship & Aging at Home; Insurance Claims, Denials & Bad-Faith Accountability; Public Health & Emergency Powers.

Status: Proposed / Draft — not yet formally adopted.

Originally published: August 15, 2026.

Last updated: September 29, 2026.

Version: Draft 0.8.