Sisters and Brothers -

Everyone knows that our current health care system is broken, dysfunctional and cruel. Despite spending almost twice as much per capita on health care as any other major country, we remain alone in not guaranteeing health care for all. Yes. Short term we have to extend the tax credits for the Affordable Care Act so that 20 million Americans don’t see, on average, a doubling in their premiums. But that’s not enough. Congressional Democrats must go on the offensive. They must not continue defending a broken system. Health care is a human right. We need Medicare for All.

Read my latest op-ed in the Boston Globe.

Republicans finally want to talk about health care. That’s good — but their ideas are absurd.
Their proposals would take our already broken health care system and make it even worse. Here’s what we should do instead.

By Bernie Sanders | Boston Globe - November 20, 2025

For months, the American people have watched the Republican Party run away from their own unpopular health care agenda. But now — finally — they have been forced to admit what the rest of us have known all along: Doubling Affordable Care Act premiums for 20 million Americans and throwing 15 million Americans off of the health care they currently have is not a winning political strategy. And Republicans like to win.

The bad news is that the health care “proposals” President Trump and his Republican colleagues in Congress are bringing forth are not merely inadequate. They are absurd. They would take our already broken health care system and make it even worse.

Trump’s big idea? Repeal the ACA tax credits that help millions afford coverage and send people a one-time check of, at most, $6,500. That would be an absolute disaster.

At a time when more than 60 percent of our people live paycheck to paycheck, a $6,500 check is meaningless in the face of real medical costs. How is someone who needs a $150,000 cancer treatment going to get the care they need with a $6,500 check? What is a pregnant woman supposed to do with a $6,500 check when the average cost of childbirth in America is over $20,000? How is someone who has a heart attack going to be able to afford a $50,000 hospital stay with just $6,500?

Trump’s approach would lead to more medical bankruptcies, more unaffordable care and more Americans dying unnecessarily in the richest nation on earth.

At a time when the majority of Americans understand that our current health care system is broken, dysfunctional, and cruel, Congress must offer serious proposals that address systemic health care deficiencies. Democrats should not be defending a system that is by far, the most expensive in the world, and one that numerous international studies demonstrate is one of the worst among high-income countries.

In America today, despite per-person spending of over $14,500 on health care annually, more than 85 million are uninsured or underinsured. The nation faces a massive shortage of doctors, nurses, dentists, and mental health professionals. Tens of millions of Americans cannot see a primary care doctor when they need one — even those who have good insurance. The country has an aging population, but nursing homes throughout the country are under-staffed, and many are shutting down. The home health care situation is a disaster.

With the health care system’s emphasis on tertiary care rather than disease prevention and primary care, life expectancy in the United States is four years lower than in other wealthy countries and, for those in the working class, it is much lower than that.

In challenging the Republicans, Democrats must be loud and clear: Health care is a human right, not a privilege. We can no longer be the only wealthy country on earth that does not guarantee universal coverage. The function of a rational health care system is not to make insurance executives and pharmaceutical CEOs even richer. It is to provide high-quality, affordable health care to every person in America.

I believe the long-term solution to our health care crisis is Medicare for All. I appreciate the 16 senators and more than 100 House member who support that legislation. But it does not yet have majority support in Congress. Not one Republican supports it.

The good news is that there are a number of much-needed reforms to the health care system that would substantially improve the lives of the American people and that could get passed in Congress right now. These policies would pave the way toward universal health care.

Here is what I believe we should do in the short term:

• Extend the enhanced ACA premium tax credits. If Congress fails to act, premiums for 20 million Americans will double, on average, by January 1, 2026. Extending these credits would buy us time — and would prevent a health care catastrophe — while we rally the American people to support fundamental changes in a failing health care system.


• Repeal the $1 trillion in cuts to Medicaid and the Affordable Care Act. Congress must also prevent 15 million Americans from losing the health care they already have by repealing the $1 trillion in cuts Trump and the Republican Congress made to Medicaid and the ACA. Studies suggest that if these horrific cuts go forward, some 50,000 Americans will die unnecessarily every year. We cannot allow that to happen.


• Expand Medicare to cover dental, vision, and hearing care. Medicare must be expanded to cover the outrageous cost of dental, vision, and hearing care. It is unacceptable that millions of seniors cannot afford to go to a dentist or purchase the hearing aids and eyeglasses they desperately need. This proposal is enormously popular. A 2024 Data for Progress poll found that 92 percent of the American people support expanding Medicare to cover dental, vision, and hearing care. All 47 members of the Democratic caucus voted for an amendment to Trump’s Big Beautiful Bill to do just that.


• Cut the cost of prescription drugs by at least 50 percent. The American people cannot continue to pay, by far, the highest prices in the world for prescription drugs. Congress should enact legislation to cut the price of prescription drugs by at least 50 percent by requiring pharmaceutical companies to charge no more for prescription drugs in America than they do in Europe or Canada. This is a policy that Trump claims that he supports. Importantly, all 47 members of the Democratic caucus voted for a similar amendment in July to ensure that Medicare pays no more for prescription drugs than Canadians or Europeans.


• Expand Primary Health Care. As broken as our overall health care system is, the state of primary care in America is even worse. Millions of Americans rely on expensive emergency rooms or end up in a hospital because they lack basic primary care. Investing in primary health care not only keeps people healthy, it saves money. Last year, the Senate Health, Education, Labor and Pensions Committee that I chaired passed bipartisan legislation to address the primary care crisis by substantially increasing funding for Community Health Centers, the National Health Service Corps, and Teaching Health Centers. This legislation would also address the massive shortage of doctors, nurses, and dentists in our country.


• Ban stock buybacks and dividends and restrict CEO compensation. According to a recent study from the Journal of the American Medical Association, between 2001 and 2022, the top health care companies in America made $2.7 trillion in profits and spent $2.6 trillion of that money on stock buybacks and dividends. Further, last year, 275 CEOs of the largest health care companies in America made a combined $3.6 billion in compensation — including the CEO of Eli Lilly, who made $113 million, and the CEO of Cigna, who made more than $50 million. That is unacceptable.

If Trump is serious about taking on the greed of what he has called the “money sucking,” “BIG, Bad, insurance companies” and preventing big drug companies from “getting away with murder,” then he should have no problem signing legislation into law to ban stock buybacks and dividends and cap the CEO pay of health care executives.

The American people know that our health care system is broken. With the country’s increased focus on health, Democrats must be strong in rallying the American people around a rational health care system that works for all, not just insurance and drug companies.

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