Leading Senate Democrats are outlining their own healthcare policy priorities as they look to develop plans that could counter changes proposed by the Trump administration and included in the One Big Beautiful Bill Act.
In a letter (PDF) led by Finance Committee Ranking Member Sen. Ron Wyden, D-Ore., the 12 senators establish three goals that will define their policymaking endeavors: reversing Republican policies that may drive up costs, simplifying the healthcare experience and taking on corporate profiteering.
In that first category, the senators said they will work to address rising premiums and costs, which have gone up in the Affordable Care Act (ACA) market following the expiry of enhanced premium tax credits for enrollees. They also said they would work to establish pathways for low-income Americans to secure coverage, particularly in states that have not expanded Medicaid.
The legislators added that they also would nix "junk insurance" plans, referring to catastrophic coverage that was expanded on the ACA exchanges under the current Trump administration.
"Over the course of this year, many American families will learn in real time that the coverage they have does not protect them from unaffordable healthcare costs at a time of crisis," the senators wrote.
Beyond policy priorities to target affordability, the Democrats said they'd push to make healthcare simpler through standardized benefits that make it easier for people to comparison shop for coverage, as well as ensuring that patients do not face undue denials or delays in accessing care.
In particular, the legislators said they would "hold Big Insurance accountable for practices that generate profits by stepping in between patients and their doctors to delay or deny access to care."
Policymakers on both sides of the aisle have taken a populist tone in discussing the insurance industry. Democrats have long questioned the size of payer conglomerates and the steps they take to generate profits. Still Republicans have also, of late, pushed on those same buttons, including charging that the enhanced ACA tax credits represented a handout to insurers.
The letter lays out several priorities in addressing the behavior of insurance companies, such as ensuring that federal payments to plans—such as those in Medicare Advantage—are using to improve quality and benefits, and not to boost profits.
They also said they would "eliminate" insurer efforts to game the medical loss ratio (MLR) to support profits, but did not outline specifics on how they may do so. Critics of the industry have argued, for example, that payers can manipulate MLR by owning providers and paying their own clinicians more, thus keeping the money in-house.
In addition, they said they would address "shell games" where insurers place "unaccountable middlemen between patients and affordable care," likely referring to pharmacy benefit managers and group purchasing organizations, which have both faced bipartisan criticism.
"In the coming weeks and months, we plan to release more details about the above policies," they wrote. "We invite any interested colleagues to join us by participating and providing input into this effort."
Other senators who signed on to the letter include Mark Warner, D-Va.; Jon Ossoff, D-Ga.; Raphael Warnock, D-Ga.; Lisa Blunt Rochester, D-Del.; Tammy Baldwin, D-Wis.; Sheldon Whitehouse, D-R.I.; Jeff Merkley, D-Ore.; Elissa Slotkin, D-Mich.; Elizabeth Warren, D-Mass.; Tina Smith, D-Minn.; and Peter Welch, D-Vt.