Senate Democrats Offer Plan to Increase Insurance Coverage, Ease Healthcare Red Tape

A dozen Senate Democrats released a plan aimed at getting more Americans health insurance coverage and making insurance plans easier to navigate.

“America’s for-profit health insurance system is fundamentally broken,” the senators said last Thursday in a “Dear Colleague” letter. Not only are families paying more for their coverage while getting less out of it, they said, families are “often finding that their health insurance is not there for them when they need it most.”

The plan has three pillars:

Reverse Cost Increases: The plan would ensure people had good access to affordable coverage that meets their needs, “explore the benefits” of giving everyone access to a “Medicare-type” option for insurance, get rid of junk insurance plans, and “eliminate surprise tax bills levied on working people who buy their own insurance.”

The plan criticizes Republicans for not extending the enhanced premium tax credits allotted to certain enrollees on the Affordable Care Act’s health insurance exchanges, which the letter says have caused more than 1 million people to lose their insurance because it has become unaffordable.

Make Healthcare Simpler: The letter notes that a majority of Americans have reported experiencing problems using their health insurance such as denied claims and delayed care. The senators plan to make insurance available through a “one-stop shop” and keep people from losing their coverage because of red tape or too-high premiums.

They also say they will standardize plans and benefits “so people can make apples-to-apples comparisons of high-quality options,” and — in what appears to be a reference to prior authorizations — hold insurers accountable when they generate profits by “stepping in between patients and their doctors to delay or deny access to care.”

Take on Corporate Greed: The plan will make sure federal spending goes toward enrollee satisfaction and high-quality care rather than “corporate profits, executive compensation, and stock price.” The senators also promise to end insurer “shell games” that include putting middlemen between patients and affordable care (an apparent reference to pharmacy benefit managers) and stop insurers from gaming the medical loss ratio (the Affordable Care Act provision that requires at least 80% of insurers’ revenue to be spent on paying claims and not on administrative costs).

“Americans are asking for a fair shake,” the senators wrote. “They don’t want to be nickeled-and-dimed or buried in red tape by the same companies that collect thousands of dollars in premiums from them each year.”

Signers of the letter include senators Ron Wyden (D-Ore.), Elizabeth Warren (D-Mass.), Tina Smith (D-Minn.), Peter Welch (D-Vt.), Mark Warner (D-Va.), Raphael Warnock (D-Ga.), Lisa Blunt Rochester (D-Del.), Tammy Baldwin (D-Wis.), Jon Ossoff (D-Ga.), Sheldon Whitehouse (D-R.I.), Jeff Merkley (D-Ore.), and Elissa Slotkin (D-Mich.).

The senators say they will release more information about the plan in the next few weeks and months.

Does this plan have much chance of going anywhere? Not likely, said Tom Miller, JD, senior fellow at the American Enterprise Institute, in a phone interview. That’s because “their incentives are to stay apart when looking at the fall 2026 [midterm] elections.”

“Each side stays in its corner, thinking they can succeed at what they’ve been doing previously rather than get into some more dangerous territory. And that’s why the two sides don’t really come together,” he said.

The Democrats’ plan is full of rhetoric complaining about “corporate greed combined with the partnership with the plutocrats running the White House,” Miller said. “There’s an irony in this, because if you look at the core Democratic health policy strategy, it’s very much in convergence with many of the interests of the health insurers, because … it wants to put more money into coverage. You may want to argue about the price you’re paying per unit, but actually the insurance industry would be happy to have a more subsidized health policy world where more of their future growth is coming from public programs.”

On the other hand, Miller said, when it comes to the Republicans, “the larger barrier is that the Trump White House believes it can go it alone. In many respects, they have enough trouble dealing with the Republican Congress, and so they would prefer to accomplish these things through regulation or White House decree or deal-making — and claim maybe more than [their plan] actually delivers, but that’s been their preferred stance.”

That’s unfortunate, because there are areas where there is actually room for compromise, he said. “If each side could get away from saying ‘My deal or no deal,’ there’s territory to do intermediate reforms” — including in Medicare Advantage, whether it’s cracking down on upcoding, implementing more appropriate reimbursement rates, or adding quality benchmarks — prior authorization practices, cracking down on abuses of drug patents, or making more drug pricing deals.

“But again, it’s not in the interest of either party to give something to the other side and share the glory — or the blame,” he continued.