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Cover everyone automatically, preserve plan choice, cap household exposure, offer a public fallback, and confront provider, drug, insurer, and administrative costs directly.
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AI-researched, unverifiedLast Reviewed
Jul 9, 2026
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What is failing, what we would change, and the conclusion we are willing to defend.
The United States spent $5.3 trillion on health care in 2024, $15,474 per person and 18 percent of the economy. Families still lose coverage when work or paperwork changes. An insurance card can coexist with a deductible a family cannot afford, a network without a specialist, or a price no one can learn in advance. Innovation begins by removing the worst design feature: in America, eligibility often exists before coverage does.
The Innovation Party supports automatic health coverage with choice:
Create a federal fallback plan that covers people before they enroll. Anyone without Medicare, Medicaid, VA, employer, or other qualifying coverage can use a national public plan at the point of care. Coverage applies throughout the uncovered period and does not wait for open enrollment. Hospitals, community health centers, and participating clinicians can activate the record. Income-based contributions are reconciled through the tax system; people eligible for fully subsidized coverage owe nothing.
Let people actively choose the public plan. Individuals, families, and small employers may buy the same plan through existing marketplaces. Private plans remain available and compete on network, service, benefits, and price. People satisfied with Medicare, VA, or employer coverage can keep it.
Put an income ceiling on household exposure. Premium contributions for benchmark coverage should never exceed 8 percent of household income and should be lower for modest incomes. Covered in-network cost sharing should be capped at 5 percent of income, with primary care, preventive care, core mental-health visits, and high-value generic drugs available before a deductible. Congress should adjust these parameters openly after actuarial review and expose unaffordability directly in the plan design.
Pay for value and access. The public plan should use a published fee schedule anchored near Medicare, with explicit adjustments for rural access, teaching, trauma readiness, pediatrics, and shortage services. Apply site-neutral payment when the same service carries the same clinical obligation. Publish access results and raise a rate when an independent review shows a network cannot serve patients.
Attack concentrated costs. Strengthen review of hospital, physician-practice, pharmacy benefit, and insurer consolidation; prohibit anti-tiering and all-or-nothing contract clauses; expand drug-price negotiation and generic competition; enforce usable prices; and standardize claims, enrollment, and prior-authorization transactions.
Pay the bill in the bill. Premiums and income-based contributions finance part of the plan. Drug, site-neutral, and administrative savings finance part. Any remaining federal cost should be covered by a progressive health-financing surcharge on very high household income. Optimistic savings and routine deficit spending cannot carry the cost.
Coverage eligibility should follow U.S. residence. Eligibility and clinical data may not be used for civil immigration enforcement. Residents still owe income-based contributions, and this expanded eligibility must appear in the public cost estimate as an explicit expense currently hidden in hospitals and states.
This is neither a forced single-payer conversion nor another subsidy attached to a fragile enrollment ritual. It makes coverage the default, lets people choose another qualified plan, and uses public purchasing power where markets are concentrated. It also admits the cost: high-income households pay more, some providers receive less, and insurers must compete with a public benchmark.
Turn frustration into useful pressure.
If this position misses evidence or a lived consequence, challenge it. If it holds up, help test it locally and connect it to the issues around it.