By any measure, health care in the United States is too expensive. Premiums are set to rise again in 2026. National filings already project increases of nearly twenty percent for many Affordable Care Act marketplace plans. Blue Cross and Blue Shield of Alabama, for example, has warned of a 19.3 percent hike. Local government employee plans in several states are also approving higher premiums. Without an extension of temporary federal subsidies, millions of Americans could face even greater out-of-pocket costs or lose coverage altogether.
The political class predictably insists that the answer is more subsidies, more mandates, and more regulation. Yet each new layer of government bureaucracy leads to higher costs, fewer choices, and reduced competition. That is not affordability. It is dependency.
The Outdated Employer-Based Model
Another structural problem lies in the outdated model that ties health benefits to employment. This approach was built for the mid-twentieth century, when many Americans worked for the same company for an entire career. At that time, job-based health insurance seemed stable and logical. Today’s economy is vastly different. Workers change jobs, careers, and even states multiple times. Health care tied to an employer leaves people vulnerable and trapped, unable to carry their benefits with them.
The Free Market Alternative: Lifetime Health Accounts
The answer is portability and ownership. Health Care Spending Accounts for life would give individuals permanent, personal control of their health dollars. Every worker, beginning with their first job, could establish such an account. Employers could contribute to these accounts in lieu of funding rigid group plans. Individuals could contribute pre-tax dollars. Families could build savings across a lifetime, carrying their benefits seamlessly from job to job and from state to state.
When combined with true price transparency, these accounts would unleash the power of competition. If hospitals, clinics, and insurers were required to post real prices upfront, consumers could shop for value in the same way they do for airline tickets or smartphones. Competition would force providers to deliver better services at lower prices. Innovations such as Direct Primary Care already demonstrate how costs fall and satisfaction rises when government and middlemen are removed.
Washington’s Way vs. a Market-Based Way
Washington has repeatedly tried to patch the system by expanding subsidies and mandates. The Affordable Care Act is the most obvious example, and its costs are now spiraling. Rather than doubling down on this failed experiment, policymakers should embrace reforms that trust people instead of bureaucracies.
The Bottom Line
Free markets drive costs down. Transparency empowers consumers. Portability breaks the outdated employer straitjacket. Lifetime Health Care Spending Accounts would provide every American with the tools to control health spending, make informed choices, and achieve lasting affordability.
It is time to stop pretending that Washington knows best. The only way to secure high-quality, affordable health care for the next generation is to trust individuals with ownership, freedom, and transparency.
Talking Points: Free Markets and Lifetime Health Accounts
The Problem
– Health care premiums are projected to rise by nearly 20% in 2026.
– Example: Blue Cross and Blue Shield of Alabama has filed for a 19.3% increase.
– Local government and employer plans across the country are also raising rates.
– The outdated employer-based model ties health care to jobs, leaving workers stranded when they move or change careers.
Why Washington’s Approach Fails
– Subsidies and mandates create dependency rather than affordability.
– Every new layer of bureaucracy drives prices higher and reduces choices.
– The Affordable Care Act is the prime example of government failure in health care policy.
The Market-Based Solution
– Lifetime Health Care Spending Accounts give workers ownership and portability.
– Employers can contribute to these accounts instead of rigid group plans.
– Individuals can contribute pre-tax dollars and carry accounts across a lifetime.
– Price transparency forces providers to compete, driving down costs.
– Direct Primary Care already demonstrates how innovation lowers costs when middlemen are removed.
Soundbite Lines
– “We do not need subsidies to make smartphones affordable. Competition makes it happen. Health care should be no different.”
– “Lifetime Health Accounts are about freedom, not dependency.”
– “Transparency is the best form of regulation.”
Historical Context
– Employer-based health insurance was created by accident, during World War II wage controls.
– It made sense when workers stayed in one job for decades.
– Today’s dynamic workforce needs portable, personal accounts, not outdated job-tied benefits.
Bottom Line
– Free markets drive costs down.
– Transparency empowers consumers.
– Portability breaks the outdated employer straitjacket.
– Lifetime Health Accounts are the only real cure for rising health care costs.