America First Reform - Healthcare Reform
America First Reform - Healthcare Reform
Our politicians have created a convoluted mess with the Affordable Care Act (ACA) — a program that expanded bureaucracy, distorted markets, and entrenched employer-based coverage that hides the true cost of insurance. The single greatest accomplishment of the ACA has been to demonstrate how incapable government is of efficiently managing a national health system.
Yet, the solution already exists within current law. We simply need to educate policymakers on what they have already authorized — and expand it to every American through a voluntary, consumer-owned model of health financing.
In 2025, total U.S. health expenditures are projected to exceed $5.5 trillion, consuming nearly 18% of GDP. Of this, government programs — Medicare, Medicaid, ACA subsidies, and tax exclusions for employer coverage — will account for over $3 trillion in taxpayer-funded costs. That’s roughly $15,500 per person, per year.
This massive outlay is the single largest driver of our national debt. Without reform, health expenditures will continue rising faster than wages, tax revenue, or inflation — guaranteeing long-term fiscal insolvency. The path forward isn’t more government mandates or subsidies; it’s empowering individuals with portable, transparent, and fair Age-Based Tax Credits to replace the hidden and regressive employer tax exclusion that props up today’s inflated system.
Our existing framework is built on Defined Benefit plans — meaning taxpayers fund open-ended obligations. Employer-sponsored insurance, Medicare, Medicaid, CHIP, and ACA subsidies are all structured this way. The federal government doesn’t set a defined budget per person; it pays whatever it costs to maintain the benefit. In 2025, that system will cost taxpayers roughly:
Medicare: $1.1 trillion
Medicaid and CHIP: $900 billion
ACA subsidies and cost-sharing reductions: $125 billion
Employer-sponsored insurance tax exclusion: $325 billion
Federal contributions and retiree subsidies: $50 billion
Total: $2.5 trillion to $3 trillion in federal and state outlays — without including the $2.5 trillion in private premiums and out-of-pocket expenses that families and employers pay directly.
Under an Age-Based Defined Contribution model, every American would receive a fixed, portable credit to purchase the coverage they want — or deposit unused amounts into a Health Savings Account (HSA). This approach transforms the government’s open-ended liability into a predictable, capped annual contribution. It restores personal ownership, market competition, and cost visibility.
The new Age-Based Tax Credit Schedule is simple and fair:
Ages 0–30: $3,000 per person annually
Ages 31–64: $3,100 to $6,400, increasing by $100 per year of age after 30
These credits would be advanceable and refundable, meaning individuals can apply them monthly to any qualified health plan or use part for direct HSA deposits. The result is predictable federal spending, expanded consumer choice, and millions of Americans moving voluntarily away from costly employer and ACA plans.
If every American under age 65 opted into the Age-Based Tax Credit model, total federal costs would be approximately $2.3 trillion annually — including both premium payments and HSA deposits. That’s compared to the roughly $3 trillion the federal government currently spends (directly and indirectly) through ACA subsidies, Medicaid, Medicare Advantage, and employer tax exclusions.
This means immediate annual savings of roughly $700 billion, or $7 trillion over ten years, without cutting a single person’s coverage. These savings come from eliminating wasteful overhead, removing middlemen who profit from employer tax exclusions, and reducing government’s open-ended exposure to medical inflation.
Even more important, these credits would allow individuals to accumulate wealth through HSAs. A family of four that saves even half of its annual deposit could build over $150,000 in lifetime medical savings, turning a lifetime expense into a lifetime asset.
As younger and healthier individuals choose portable coverage, employer-based insurance will gradually unwind on its own — not by government mandate, but through consumer preference and financial incentive. This voluntary transition is the hallmark of the America First Reform model: a scalable, market-driven path that restores freedom and fiscal sanity while guaranteeing affordability and personal ownership.
0 – 30-year-olds make up 38% of the population or 130 million people x $3,000 tax credits = $390 Billion
31-49 -years old’s make up 25% of the population or about 86 million people x average cost of the tax credits = $344 Billion
50 – 64-years old’s make up 19%% of the population or about 63 million People x average cost of tax credits = $359 Billion
65 – 84 -years old’s make up 15% of the population or about 49 million People x average cost of tax credits = $365 Billion
84+ -years old’s make up 3 % of the population or about 7 million People x average cost of tax credits = $63 Billion
Total of all age-based tax credits = $1.5 Trillion.
Our current healthcare financing system is an unsustainable relic of mid-20th century labor policy. It ties coverage to employment, rewards inefficiency, and punishes independence. Age-Based Tax Credits offer a transparent, equitable, and fiscally responsible solution.
By giving every American a defined contribution rather than an undefined promise, we can lower costs, reduce debt, and create a permanent structure that honors both freedom and fairness. The numbers are clear: with predictable credits, personal responsibility, and HSA ownership, the nation can save trillions of dollars while giving citizens something the current system never has — control over their own healthcare future.