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Too many Americans can’t afford health care. Families struggle under the weight of high costs, limited choices, and frustrating uncertainty. Everyone should have access to the high-quality health care they need, when they need it, at a price they can afford. It’s time to liberate doctors, patients, scientists, and inventors to make health care better, more affordable, and more available for every single American.

Our Vision

What Americans want:

  • To see the doctor of our choice, conveniently and affordably.
  • Access to the most appropriate treatments.
  • Access to good insurance that meets our needs at an affordable rate.
  • To know how much our care will cost, up front, before we have to pay for it.
  • Strong safety nets that protect the well-being of the poor and vulnerable.

In many ways, our health care system works quite well. The United States boasts the best cancer survival rates in the world and some of the shortest wait times. And we remain the world’s leader in developing new, life-saving therapies and cutting-edge technologies.

But improvement is needed. Health care costs are too high for Americans. And too many families experience the heartbreak of a bankruptcy due to high medical bills.

Most Americans are not calling for a government takeover of health care. We just want to fix what is broken and preserve what works.

Some people say the answer is a government takeover of health care (“Medicare for All” or “a public option”). While that simple “solution” might sound appealing, it cannot guarantee the basic protections people need. People in countries with government-run, single-payer health care typically endure chronic medical shortages, long waiting lists, and bureaucratic rationing. Tragically, it the most vulnerable who suffer the most under such systems: the sick, the elderly, and people with chronic medical conditions.

Even a “public option” approach will cause tens of millions of Americans to lose their existing health plan and will inevitably lead to a government takeover that means higher costs and less access for everyone. It will make it harder for people to get the care they need when they need it.

Instead of a “public option,” Americans need a Personal Option: universal access to affordable, high-quality care – without a government takeover.

How can we achieve such an option? First, we need to reimagine health care and not let ourselves be trapped by old thinking. Second, we need to pursue four basic goals:

  • Expand access
  • Reduce costs
  • End surprises
  • Ensure safety nets

What follows are the specific reforms, and the legislative proposals, that we believe can create a Personal Option.

  1. Expand Access 

Congress should expand and strengthen tax-free Health Savings Accounts (HSAs), so more families can benefit from this powerful savings tool and use it for more kinds of care and coverage, including, for example. direct medical care subscriptions (convenient, round-the-clock access to a trusted doctor):

  • The Personalized Care Act (S.3112 by Sen. Cruz, H.R.5596 by Rep. Roy)

Congress should unleash a digital health revolution – and save lives – by making telehealth available in Medicare:

  • The Telehealth Innovation & Improvement Act (S.773 by Sen. Gardner, H.R.4013 by Rep. Curtis)
  • The CONNECT for Health Care Act (H.R.4932 by Rep. Thompson, S.2741 by Sen. Schatz)
  • The Coronavirus Regulatory Repeal Act (H.R.6691 by Rep. Roy)

States should expand the supply of hospitals and cutting-edge technology, and thus reduce costs, by repealing local “certificate of need” laws:

  • The Creating Capacity for Communities in Need Act (S.3547 by Sen. Cruz)
  • The Increasing Hospital Capacity to Fight the Coronavirus Act (H.R.6336 by Rep. Bishop of N.C.)

States should let medical professionals practice across state lines by automatically recognizing the licenses of medical professionals licensed in other states.

State and federal policymakers should allow nurses and physicians assistants to provide the services they’re trained for, where they’re needed, regardless of where they’re licensed:

  • The Coronavirus Regulatory Repeal Act (H.R.6691 by Rep. Roy)

The federal Food and Drug Administration (FDA) should allow free speech in medicine so drug manufacturers can legally share with doctors truthful and non-misleading information about off-label uses of their drugs.

To speed new life-saving therapies to market, Congress should require automatic FDA recognition of drugs that have been approved by countries we trust:

  • The RESULTS Act (S.2161 by Sen. Cruz and H.R.6258 by Rep. Roy)
  • The RESULTS for Coronavirus Patients Act (S.3545 by Sen. Cruz, H.R.6260 by Rep. Roy)

Congress should bring down the cost of prescription drugs through competition:

  • The Lower Costs More Cures Act (H.R.19 by Rep. Walden)

Congress should ensure safe and reliable diagnostic tests in a public health emergency:

  • The Right to Test Act (S.3769 by Sen. Cruz)
  1. Reduce Costs 

Congress should expand access to workplace health reimbursement arrangements (tax-free money for health care):

  • The Increasing Health Coverage through HRAs Act (H.R.5224 by Rep. Bishop of N.C.)

Congress should enable people to buy health insurance tailored to their needs by expanding access to short term renewable plans, which are typically 50% to 80% less expensive than traditional plans:

  • The Health Coverage Choice Act (H.R.4811 by Rep. Biggs)
  • The Affordable Health Care Options Act (S.3821 by Sen. Loeffler)

Congress should let individuals and businesses band together to buy affordable coverage at group rates:

  • The American Healthshare Plans Act (S.3610 by Sen. Rand Paul)
  • The Association Health Plans Act (S.1170 by Sen. Enzi, H.R.2294 by Rep. Walberg)

Congress should restore robust, thriving health insurance markets by channeling all of the funding and mandates of the deeply flawed Affordable Care Act (ACA) back to the states, while retaining protections for people with pre-existing conditions.

  • A Plan for Personalized, Affordable Health Care (House Republican Study Committee)
  1. End Surprises 

Federal and state policymakers should adopt sensible rules to promote price transparency and truth-in-advertising, so patients know what their care will cost, up front, before they have to pay for it.

Congress should repeal federal policies, such as the insurance mandates of the Affordable Care Act, that incentivize insurers to deny patients access to doctors and hospitals via narrow networks.

  1. Ensure Safety Nets 

Congress should modernize and strengthen Medicare to give seniors more freedom and better access to doctors and therapies at lower cost:

  • Health Savings for Seniors Act (H.R.3796 by Rep. Bera)
  • Retirement Freedom Act (S.1030 by Sen. Cruz, H.R.2108 by Rep. Palmer)

Congress should restore Medicaid to its original mission of being a safety net for the most vulnerable by transforming it into a system of generous, flexible block grants to states, with the grants capped at a level taxpayers can afford.


There is no single, simple cure for what ails American health care. A government takeover would only make things worse. Doubling down on the failed status quo would be a terrible mistake.

Instead of a “public option,” America needs a Personal Option: a set of sensible, principled reforms that would make American health care better, more affordable, and more accessible for everyone – and the envy of the world.