25 Feb We Need More Patient-Centered Reform to Improve U.S. Healthcare: A Response to the 2026 State of the Union
The 2026 State of the Union address introduced a vision for a “Great Healthcare Plan” centered on consumer choice and increased transparency. While the focus on lowering costs is a welcome starting point, true reform requires looking beneath the surface. We must ensure that new policies don’t just work for those who can navigate complex systems but also provide a reliable safety net for all neighbors, regardless of their background or income.
To build a system that truly serves everyone, we encourage the administration and Congress to focus on these five key pillars of patient care:
1. Break Up Insurer-PBM Monopolies: Transparency is a great first step, but it cannot fix a rigged market. Today, giants like UnitedHealth Group (UHG) generate nearly 40% of their revenue by steering patients through a closed loop of 2,700 subsidiaries. When an insurer funnels 50 million people toward the 90,000 doctors it controls, it makes a mockery of the Affordable Care Act’s intent. By shifting money between subsidiaries and marking up medicines by over 10x through PBMs like OptumRx, these corporations hide billions in profits while families face higher bills and fewer choices.
2. Put Patients and Providers First: Insurers should not be allowed to override clinical judgment. Currently, insurance conglomerates employ more than seven in 10 doctors, often pressuring them to refer patients to in-house specialists even when independent providers offer better, more affordable care. Furthermore, “prior authorization” hurdles have become deadly; up to 82% of patients facing these hurdles abandon treatment altogether. We must ensure that medical decisions remain between a patient and their doctor—not a corporate bottom line.
3. Strengthen the Foundation: Medicaid, Medicare, and Innovation: As the administration seeks to eliminate waste and fraud, we must protect the essential services Medicaid provides to low-income families and rural communities while honoring Medicare as a sacred trust. Ensuring these programs remain robust is only half the battle; we must also restore funding for critical federal research programs that serve as a lifeline for patients with disabilities. By reinvesting in the science behind mobility, sensory function, and cognitive health, we ensure that medical breakthroughs move from the laboratory to the people who need them most. This also includes expanding access to GLP-1 medications, which offer a transformative opportunity to combat chronic conditions like obesity and diabetes. We are supportive of modernized policies that enable Medicare and Medicaid to cover these treatments, ensuring that life-changing innovation is not a luxury for the few. By prioritizing both cutting-edge research and immediate access to treatment today, we can prevent the long-term, astronomical costs associated with heart disease, stroke, and kidney failure tomorrow.
4. Enhance Integrity and Oversight to 340B: The 340B Drug Pricing Program was established to support safety-net providers, but its rapid expansion has led to significant market distortions. We support sensible reforms that increase transparency and ensure the deep discounts provided by manufacturers are utilized for their original intent. Currently, many multi-billion dollar hospital systems and for-profit pharmacy chains take advantage of the program’s lack of oversight to generate massive revenue “spreads.” This often occurs without any requirement to pass those savings directly to the patient at the pharmacy counter. To protect the program, Congress must ensure that 340B savings are reinvested into the community health centers that need them most, rather than padding the bottom lines of large hospital conglomerates.
5. Restore Trust in Public Health and Medical Innovation: A healthcare system cannot function without the trust of the people it serves. We must move toward a public health model that reaffirms the value of science-driven medical intervention. This means fostering a culture that recognizes modern medicines and vaccines as high-quality, life-saving treatments that undergo rigorous testing to ensure safety and efficacy. By protecting the integrity of the clinical process and ensuring that politics stays out of the pharmacy, we can restore public confidence in the innovations that have nearly eradicated once-deadly diseases and continue to extend the American lifespan.
The 2026 State of the Union laid out a vision, but the American people need a reality where their health is not a secondary concern to corporate profit. We cannot achieve a “Great Healthcare Plan” as long as public dollars are siphoned into off-shore tax havens by insurance middlemen or used to fund hospital expansions rather than patient discounts. It is time for Congress to rein in the insurance giants, ensure transparency in hospital spending, and return the focus to the only metric that matters: the health and dignity of the American patient.