Pfluger’s Plan Won’t Fix Our Healthcare Woes

ANALYSIS AND COMMENTARY

After looking his constituents in the eyes during a town hall meeting in San Angelo earlier this year, telling them they were dead-wrong about people losing Medicaid benefits and health care premiums spiking, it looks like next year is shaping up to be a harsh reality check for Rep. August Pfluger of San Angelo, and everyone who voted for him.

Every healthcare expert in the nation, and reports from industry leaders, are all in agreement; healthcare premiums for about 24 million Americans are expected to double or triple in 2026, due only to changes in the Republican’s “Big, Beautiful Bill.”

Medicare premiums are increasing for all parts in 2026, and many hard-workers, retirees and low-income Americans are expected to lose their insurance coverage due to an inability to pay.

According to a press release from Rep. Pfluger on Wednesday, he and cosponsor Rep. Aaron Bean of Florida think a plan to honor the president through the establishment of more “bank” accounts that have Trump’s name on them will go a long way toward solving our problems.

Experts think the plan could very well crash the whole health insurance system, and many suspect that’s actually the point.

POLITICO.COM — NOV. 11

According to original reporting from Politico.com on Nov. 11, the plan is being advertised as a way channel money away from insurers, ostensibly putting cash directly in consumers’ hands.

There’s just this one pesky problem.

“Economists and policy experts suspect President Donald Trump and GOP lawmakers are presenting this alternative to extending the enhanced Affordable Care Act subsidies because they want to undermine or even replace Obamacare — something the party has repeatedly failed to do in the past,” wrote Politico’s Kelly Hooper and Robert King.

“With direct cash payments from the federal government into special accounts, “healthy people could get much cheaper insurance that has medical underwriting and doesn’t cover preexisting conditions, but that would leave much sicker people in the ACA pool, and likely send it into a death spiral,” said Larry Levitt, executive vice president for health policy at KFF, a nonpartisan research organization.

If younger, healthier consumers choose such so-called junk health plans — with lower costs and less robust coverage — or don’t use the money for health insurance, it could throw off the balance of risk and prompt insurers to exit the market entirely, Levitt and others said.

Make America Care Again?

Pfluger is championing a bill styled as the “More Affordable Care Act” (MACA), which aims to rescue all of America through “Trump Health Freedom Accounts,” and a few other measures.

According to a news release on Wednesday, Pfluger said Republicans are going to “Fix Obamacare’s Failures…”

The congressman’s press release begins by suggesting that everything wrong with healthcare in America today is attributable to former Pres. Barack Obama, Obamacare, and the Democratic party, and he touts this legislation’s aim to “redirect power away from insurance companies and federal bureaucracies and putting it back into the hands of consumers.”

“The Democrats’ Obamacare disaster completely failed to deliver on its core promises, and Republicans must fix it,” Pfluger proclaimed.

But anyone with a memory stretching back a few decades knows it wasn’t Barack Obama or “The Democrats” who turned American healthcare into what it is today.

It was capitalism. Pure and simple.

And it had the broadest-possible bipartisan support.

Who Should Americans Blame for Healthcare Woes?

Nailing down the exact moment when American healthcare changed forever isn’t too difficult.

Most experts agree it was the landmark HMO Act of 1973 that fundamentally altered the relationship between healthcare providers and their patients, as the group now known as “Generation X” became the first bunch in decades to grow up with fewer doctor visits than their (Baby Boomer) parents.

Living in an era where both sides perpetually blame the other for every societal ill, it’s worth noting that the HMO Act was championed by President Richard Nixon himself, hand-in-hand with Massachusetts’s Democratic Senator Ted Kennedy.

The idea was sold to the American people as a smart, business-like way to offer organized care with lower costs, replacing traditional fee-for-service models.

It offered “freedom” and “choices.”

Prior to 1973, most health insurance was provided by non-profit entities, like Blue Cross, which originated in 1929 when a vice president at Baylor University Hospital in Dallas developed a plan to provide a hospital-care plan for teachers with a monthly payment of 50-cents. That seemed pretty affordable to teachers earning about $100 a month.

The model gained popularity right away, leading to the establishment of similar plans in other states.

But beginning in 1974, the HMO Act authorized billions of taxpayer dollars to build up burgeoning health insurance networks, which subsequently grew into the behemoth health insurance companies Americans are so fond of today.

How Did We Get Here?

The idea that every problem in America was caused by somebody other than Republicans is feeble and childish.

Republicans have held power in half the states for the lion’s share of three decades, and they’ve had federal executive power for 33 of the last 57 years. (58%)

Clearly, the Republicans in quite a few congresses could have done something about all of these problems earlier, if they had wanted to.

Healthcare in America was already a problem long before Obama entered the national spotlight.

Instead of offering a meaningful replacement plan, today’s Republicans seem to be working to dismantle every single thing Americans have worked together to build over the last century.

Except the military, of course.

But for just about everything else, this group seems to employ the following long-term strategy — from public-school education to healthcare.

1. Claim that a thing isn’t working well, and sell people on the all-American idea that only someone from big business can fix the problem with business ideas.
2. Identify every dollar that isn’t nailed down and streamline things to save money at every opportunity.
3. Channel available dollars to business interests.
4. When problem isn’t solved, continue coming up with cockamamie ideas to annoy target groups (teachers/doctors/patients), and blame the failure on literally anyone else.
5. Repeat until things are broken beyond repair.
6. Declare the problem unsolvable.
7. Sell off all assets for profit.

Demonizing Obamacare

Despite constant opposition to Obamacare, the Republicans have never actually proposed any credible legislation to replace it, or fix everything in American healthcare, despite having more than a decade to do so.

According to many healthcare insiders, the Affordable Care Act was always a piece of compromise legislation designed to bring health coverage to some of the 45- to 50 million uninsured people in America, and protect the healthcare sector’s profits as the economic crisis of the Housing Bubble continued to wash over Wall Street.

“Name something that every Republican hates…”

According to reporting at that time, an estimated 16 percent of the population — almost exclusively low-income adults and young people — were uninsured, with estimates showing about 48.6 million in 2010, and around 44 million in 2013, just before significant ACA coverage began.

The disastrous failure Rep. Pfluger and his colleagues so frequently reference — OBAMACARE! — as of early 2024/2025 — allowed more than 45 million Americans to get some kind of insurance through ACA Marketplace plans, Medicaid expansion in some states (not Texas), and the Basic Health Program, representing the highest enrollment in history.

But that’s not all the ACA did.

Obamacare also forced unwanted changes on everyone else’s insurance.

Changes like making insurance plans more comprehensive and protective, ending denials for pre-existing conditions, eliminating lifetime and annual limits, covering essential benefits like mental health and maternity, mandating free preventive care, allowing children to stay on their parents’ plans until age 26, and creating subsidies for most low-income Americans.

Guess it was that last part they hated the most.

To protest, red-state Republican leaders valiantly sued the federal government, and showed the Obama Administration the back of their hand by opting-out of the Medicaid expansion available to the poorest residents of all states, as authorized by Congress.

It’s a good thing poor people in Texas had Republicans making sure they didn’t get any socialism on them.

Although it’s often news to residents of the Lone Star State, everyone else in the country knows Texas has been at the top of the list for states with the most uninsured residents for decades.

That’s actually one of the reasons Texas regularly ranks as No. 1 for business year after year.

It’s Not All Bad

To its credit, the bill does make meaningful provisions for small-business tax relief to spur employer-sponsored coverage.

A significant portion of Texas businesses, especially those with fewer than 100 employees, don’t offer health insurance, with most citing cost as the primary barrier, according to research.

Studies show about 30-percent or more of very-small firms, with fewer than 10 employees, don’t offer coverage, and about one-fourth of mid-sized firms (10-24) opted out or struggled to keep up with premium increases, contributing to Texas’s high rate of uninsured residents, according to data from HR Brew, Texas Border Business, and Texas 2036 in reports from 2023-2024.

However, it’s entirely up to the individual businesses if they will offer health coverage.

(Of note: even critics of this bill say they would welcome changes like lowering the eligible employee threshold from 25 to 20, removing the $57,000 salary cap, and increasing the tax credit to 50-percent for all qualifying employers.)

The bill also aims to lock-in price transparency for patients, according to its authors, but critics point out that President Trump’s executive order on hospital price transparency isn’t really being enforced by the administration itself, which seems staunchly opposed to any kind of regulatory enforcement.