Democratic proposals to repair America’s broken healthcare system have reliably shown a slide towards healthcare-for-all. But for the first time since the modern healthcare system began, Republicans have what they say is an answer.

"Democrats made health insurance illegal in the United States. You can't buy health insurance. All you can buy is a health care plan. We need to allow people who just want 'I got hit by a bus, or I got cancer' insurance to buy that, and they can say, 'I can take care of everything by myself.' We need to solve that health insurance problem. Democrats have caused all of these problems, but it is now our job to fix them all, and we're laser focused on doing it well," Rep. Randy Fine, R-Fla., told Just The News exclusively.

Republicans lay out their plans: direct deposits

One recent proposal from Senate Republicans Bill Cassidy of Louisiana and Mike Crapo of Idaho involves a plan to redirect expiring enhanced Affordable Care Act (ACA) credits into direct HSA deposits ($1,000 for ages 18-49, $1,500 for 50-64) for low- to middle-income individuals buying bronze or catastrophic plans. Their proposal would require Medicaid citizenship verification and bar funds for abortions or gender-affirming care. This aims to shift aid from insurers to individuals, potentially reducing premiums by promoting cheaper high-deductible plans.

The Republican brainstorming to patch ACA has been all-hands-on-deck. Rep. Austin Scott, R-Ga., spoke to Just The News and brought his own ideas to the table including the crucial competition factor: "The way to fix this is to put competition back into the system. And get rid of the pharmacy benefit rent managers, get rid of all of these middle people that have driven up the cost of health care."

"We have so few insurance carriers. We need to make clear is that an individual state has the right to license individual health insurance products to be sold in that individual state. And then, if they want to have some type of joint service agreement between [bordering states] like Alabama, Georgia, Florida, makes plenty of sense to me. But we have to get smaller companies into the business to put pressure on the big companies."

"We do not need to be doubling down on a broken system": Onder

Rep. Bob Onder, R-Mo., also championed Republican solutions to Obamacare. He recalled many of the early issues of Obamacare and told Just The News, "The very year the Obamacare exchanges were implemented in 2014, insurance prices went up 47% one year, and since then, they've gone up 98%, so we do not need to be doubling down on a broken system." 

Emphasizing a free-market approach to healthcare, he added, "We need to be introducing market-oriented, consumer-choice driven reforms...things like expanding health savings accounts, association health plans where groups of employers or other groups can get together and form their own plans, short term health plans where people can buy the insurance that they want and need, not a one-size-fits-all, extremely expensive plan that some bureaucrat wrote for them."

Another plan via House Speaker Mike Johnson, R-La., focuses on expanding association health plans for group purchasing of cheaper coverage, restoring cost-sharing reductions to lower out-of-pocket costs, and increasing pharmacy benefit manager transparency to reduce drug prices. It codifies HSA rules and bundles prior bipartisan measures but avoids extending enhanced subsidies to curb spending. 

Fine also spoke about issues surrounding transparency in healthcare. He noted, "When you divorce people from the cost of things they buy, they don't pay attention. Life insurance has gone way down in price over time because you buy it yourself. Health insurance has gone way up over time because you have no idea."

Fine highlighted his solution to this, which is: "Most people get their insurance through their employers. When they find out what their employers are paying for their insurance, they go crazy. The reason you get your insurance through your employer is its tax advantage. If we let people buying their own insurance get the same tax advantage, we can then tell employers don't do it anymore. Just pay people more and let them buy it themselves, and then people will start to shop around. When you take that incentive away from people, costs go out of control. And that is what has happened here."

Yet another fix emphasizes funneling federal health funds directly to individuals via expanded HSAs or similar accounts for catastrophic/high-deductible coverage, criticizing insurer subsidies and aligning with broader patient-directed aid. This plan reflects many of the proposals stated by President Trump and a number of Republicans who have made similar proposals, most similarly by Rep. Eric Burlison, (R-Mo.), who introduced the idea of MAHA (Make America Healthy Again) accounts.

Government shutdown exposes subsidy mess

The recent federal government shutdown, which lasted 43 days from October 1 to November 12 and became the longest in history, stemmed primarily from a partisan dispute over extending enhanced Obamacare premium tax credit subsidies set to expire at the end of 2025. Senate Democrats blocked Republican appropriations bills until a separate vote on the subsidies was promised. 

The enhanced subsidies, affecting around 24 million enrollees and projected to cost hundreds of billions if extended, were a key Democratic demand to prevent sharp premium increases for low- and moderate-income Americans, though the final continuing resolution funded the government without including the extension. 

The White House pointed out that under former President Joe Biden, millions of illegal immigrants were granted entry into the country who benefited from the subsidies, which Republicans vehemently opposed. 

Timeline of efforts to bring socialized healthcare to America

In 1945, Democratic President Harry Truman proposed a national health insurance plan for all Americans, facing opposition including $1.5 million in lobbying by the American Medical Association in 1948. That's $27 million in 2025 dollars. 

The Democratic-sponsored Wagner-Murray-Dingell Bill, introduced in 1943 and reintroduced annually for the next 14 years, sought compulsory national health insurance via payroll taxes but failed amid accusations of socialism. 

Then in 1965, Democratic President Lyndon B. Johnson enacted Medicare and Medicaid after decades of effort, providing coverage for the elderly and poor that grew to enroll nearly 75 million in Medicaid by the 2010s as partial steps toward universal systems. Those programs were centerpieces of LBJ's "Great Society" plan.

In 1993, Democratic President Bill Clinton's Health Security Act aimed for universal coverage through regulated private insurance but collapsed due to industry and partisan opposition. From 2003, Democratic Representative John Conyers introduced Medicare for All bills annually, starting with 38 co-sponsors and reaching 124 in 2017. 

By 2025 in the 119th Congress, Representative Pramila Jayapal's version had 110 co-sponsors, while Senator Bernie Sanders' had 17, showing sustained Democratic support for a single-payer system. 

The biggest advancement toward Democrats' vision of healthcare came with the Affordable Care Act, enacted in 2010 under President Obama, which expanded coverage to over 20 million Americans through marketplaces and Medicaid expansion, reducing the uninsured rate from around 14% in 2013 to about 8% in recent years. 

It turns out that ACA cost Americans more

It was described by then-Senate Majority Leader Harry Reid in 2013 as a step toward eventually moving past insurance-based healthcare to a single-payer system.

However, individual market premiums rose sharply, post-implementation, with average increases exceeding 100% in many analyses from 2013 to 2019, far surpassing pre-ACA trends. Many enrollees also encountered reduced scope of coverage, with rising deductibles—averaging over $7,000 on popular bronze plans—and narrower networks limiting provider choices and comprehensive benefits.