Trump is keeping his word on health care costs



For years, Washington insiders from both parties talked a big game about lowering health care costs. Yet somehow, the bills kept rising, families kept struggling, and the real power players in the system kept getting a free pass. Not anymore.

The Trump administration’s Department of Justice is finally taking aim at one of the biggest and most overlooked drivers of high health care costs: anticompetitive contracting by dominant hospital systems.

Hospitals are businesses first and foremost — and like any business, they’re out to maximize profits.

The recent lawsuits against giants like New York Presbyterian and Ohio Health are a clear signal that the era of unchecked hospital power is coming to an end.

Let’s be honest about what’s been happening. In city after city, hospital markets have quietly consolidated until competition barely exists. When nearly all metro areas have highly concentrated hospital systems, those systems use their leverage to lock in contracts that guarantee them top-tier placement in insurance networks while blocking efforts to guide patients toward more affordable care.

These so-called “anti-steering” provisions might sound technical, but their impact is simple: higher prices and fewer choices for American families.

When insurers and employers cannot design plans that reward lower-cost, high-quality providers, patients are forced into more expensive options whether they realize it or not. Workers pay more in premiums. Businesses face higher costs. Taxpayers pick up the tab through government programs.

What makes the Trump DOJ’s actions so important is that they are willing to challenge institutions that have long been treated as untouchable. Hospitals often enjoy a halo effect in their communities, and many do lifesaving work. But that does not give them the right to use their market dominance to shut out competition and inflate prices.

Hospitals are businesses first and foremost — and like any business, they’re out to maximize profits.

By going after these restrictive contracts, the administration is restoring something that has been missing from health care for far too long: real competition. When plans have the flexibility to exclude overpriced systems or steer patients toward better-value options, the entire market starts to work the way it is supposed to.

We already have evidence this works. Plans that avoid the most expensive hospital systems can significantly reduce costs — without negatively impacting the quality of the care being delivered — and even modest steering can deliver meaningful savings. In a system as large as American health care, those savings translate into billions of dollars and real relief for families.

Predictably, the corporate hospital industry is pushing back, claiming these lawsuits are misguided. But that is what you hear whenever someone finally challenges entrenched interests. The same voices that benefited from the status quo are now being asked to compete on a level playing field, and they do not like it.

RELATED: Tax-exempt hospitals are not putting their patients first

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Instead of protecting powerful institutions, the Trump administration is standing up for patients, workers, and employers who have been footing the bill for far too long. It is a reminder that markets only work when competition is protected, and that means enforcing the rules when they are violated.

For decades, Americans have been told that health care costs are just too complicated to fix. But sometimes the problem is simpler than the experts admit. When a few dominant players can write the rules, everyone else loses. President Trump and the Department of Justice are finally rewriting that script.

Draining the swamp is not just about Washington politics. It is about rooting out the hidden arrangements and insider advantages that drive up costs across our economy, including in health care.

By taking on anticompetitive hospital contracting, the Trump administration is proving that no industry is above scrutiny.

That is a win for competition, a win for affordability, and most importantly, a win for the American people.

Tax-exempt hospitals are not putting their patients first



There is something seriously wrong with American health care. Rising costs mean that Americans now pay nearly twice as much as people in similar countries, without getting better outcomes. “It’s complicated,” say those who want to keep prices high and rising. But some of it is simple, as my organization is showing with research on hospital systems like Cleveland Clinic.

Hospital executives are leading luxurious lifestyles while claiming that every dollar spent — on television commercials, Abu Dhabi real estate, or modern art — is 'health care.'

A longtime household name, Cleveland Clinic presents itself as an altruistic institution focused on health and patients. As a tax-exempt corporation, everything Cleveland Clinic does is subsidized by taxpayers, and it receives many other direct and indirect benefits in the interest of public health. Yet it pays executives millions, has massive holdings overseas, and maintains a collection of fine art.

Why are your health care bills and insurance premiums going up? Why is government spending and borrowing more and more to subsidize care? Look no farther than the misplaced priorities of profit-maximizing “nonprofit” hospitals like Cleveland Clinic.

Recent news has exposed massive waste and fraud against taxpayers in places like Minnesota, California, and Washington state. Yet the problem is deeper and more systemic. Rooting out actual theft is essential. So is confronting waste and abuse, especially within large health care institutions.

Last month, Save Our States launched a campaign calling out a massive hospital system run by the University of Miami. While its transplant center was failing, hospital executives were focused on building a lavish new lobby and expanding into Abu Dhabi.

Our new exposé on Cleveland Clinic found surprisingly similar luxury expenses. It has an in-house art museum, for example, boasting a "world-renowned collection" of nearly 7,000 pieces of contemporary art. Like many hospitals, it spares no expense on public relations and advertising — Cleveland Clinic even ran its own Super Bowl ad.

The clinic pays millions in executive salaries. Those executives are planning a massive new sports center with the Cleveland Cavaliers, to go along with their fancy foreign facilities in places like London, Toronto, and — once again — Abu Dhabi.

How do these expenses benefit American patients? And why should taxpayers subsidize any of it?

Some medical providers do pay taxes. A doctor with an independent practice gets taxed like any other business. But sell that practice to a tax-exempt hospital, even one with billions in revenue, and suddenly it becomes tax-exempt. At the same time, hospital-owned practices often start adding “hospital facility fees” on top of regular bills.

They charge patients more for the same services, then pay less in taxes. No wonder massive hospital systems buy up smaller practices and facilities. These are policy choices, not market forces, driving consolidation in health care. The result is lower quality, higher prices, and misplaced priorities.

RELATED: America has a spending problem Congress refuses to fix

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For many Americans, the rising prices go first to their insurance, later showing up in rising premiums and lower take-home pay. And all Americans see the cost in taxes. Everyone pays somehow, in higher costs, less access to care, or both.

Meanwhile, hospital executives are leading luxurious lifestyles while claiming that every dollar spent — on television commercials, Abu Dhabi real estate, or modern art — is “health care.”

During its spending spree, Cleveland Clinic has faced allegations of deceptive billing, accusations of overcharging patients, reports of underpaying nurses, and stories of medical debt lawsuits brought against its own patients.

Our new site, ClevelandClinicBetrayedPatients.com, documents the misplaced priorities of this massive, taxpayer-supported hospital system.

Given that Cleveland Clinic is in Vice President JD Vance's home state of Ohio, hopefully he can make it a focus of his new appointment by President Trump to lead the “war on fraud.” The vice president and congressional leaders need to scrutinize spending at all subsidized hospitals — starting with the biggest.

The question is not: “Does it do some good somewhere?” One good program does not justify waste elsewhere. The question is: “Are any taxpayer dollars subsidizing waste, abuse, or unnecessary extravagance?”

Americans need health systems that respect taxpayers and put patients first. More than anything, we need the kind of competition that creates accountability, demands transparency, fosters innovation, and produces better services at lower prices.

Trump has delivered on rural health care



Rural health care in America faces a host of chronic challenges: high costs, limited access, and aging infrastructure. For millions of families across the heartland, these problems aren’t abstract — they determine whether patients can see a doctor, reach a hospital, or receive timely care close to home.

By expanding flexibility, encouraging innovation, and meeting rural communities where they are, policymakers have begun to confront the unique realities of rural health care.

More than 60 million Americans — nearly one in five — live in rural areas where patients routinely travel long distances only to find fewer doctors, hospitals, and clinics available to serve them.

Under-resourced communities face over-sized health challenges. Nowhere is this more evident than in rural America, where higher rates of chronic disease, premature mortality, and addiction persist compared to the rest of the country.

In recent months, the Trump administration and Congress have advanced a set of reforms — largely overlooked in the national debate — that directly address long-standing disparities and structural weaknesses in rural health care, and they could meaningfully strengthen care delivery in these communities, improve health, and save lives.

The most significant of these efforts is the Rural Health Transformation Program, established last year in President Trump and the Republican Congress’ signature One Big Beautiful Bill Act. This $50 billion program represents the largest investment ever dedicated specifically to rural health, far exceeding the scale of prior grant programs. States that receive awards can use these resources to modernize and stabilize their rural health systems.

The program allows states to invest in innovative care models tailored to rural realities — whether expanding outpatient capacity, strengthening the health care workforce, or upgrading aging facilities. Instead of imposing a one-size-fits-all approach, the program gives states the flexibility to design reforms that reflect local needs and constraints.

Although media attention has shifted elsewhere, the White House and congressional leaders should continue to emphasize the long-term importance of this investment. The program addresses a foundational weakness in America’s health system and delivers tangible support to rural communities that have too often been left behind.

As part of the recently enacted FY 2026 appropriations legislation, Congress also extended Medicare telehealth flexibilities through December 31, 2027, delaying a return to statutory barriers that once limited access to telehealth services. Telehealth allows patients to connect with specialists, receive mental health services, and manage chronic diseases without traveling hours for an appointment.

In communities facing persistent provider shortages, telehealth has become not a convenience but a lifeline — a bridge over miles of empty road, connecting rural patients to care that would otherwise remain out of reach.

The FY 2026 appropriations legislation also reauthorized the Acute Hospital Care at Home initiative, which allows eligible patients to receive hospital-level care in their own homes. This approach reduces costs, eases pressure on rural hospitals with limited capacity, and improves patient satisfaction. For small hospitals struggling to keep beds staffed and doors open, Acute Hospital Care at Home offers a practical way to deliver high-quality care while preserving local access.

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Finally, although Congress has not yet enacted it into law, lawmakers are working to reauthorize the Rural Health Care Services Outreach Program. This program supports community-based efforts to expand access to care, strengthen coordination among providers, and address persistent service gaps. Its grants help rural health systems collaborate across institutions and tailor solutions for populations that too often fall through the cracks.

Taken together, these reforms do not promise a quick cure — but they do offer a realistic treatment plan. They don’t strengthen rural health care because it’s easy; they make it easier because rural health care must be strong. While these efforts will not eliminate every challenge rural communities face, they are designed to deliver tangible improvements that deserve recognition.

By expanding flexibility, encouraging innovation, and meeting rural communities where they are, policymakers have begun to confront the unique realities of rural health care. Yet as the news cycle moves on, these achievements risk being overlooked. Policymakers in both Congress and the executive branch should resist the urge to rush to the next challenge and instead highlight the significance of these steps in the right direction.

Editor’s note: This article was originally published by RealClearHealth and made available via RealClearWire.

As legislative season begins, lawmakers should be careful about PBM 'reform'



As state lawmakers begin to return to office this week, a number of issues will be clamoring for their attention. One of the most important — but perhaps overlooked due to its technical and less attention-grabbing nature — is pharmacy benefit manager reform.

Reform-minded leaders should work with PBMs, leveraging their market power to achieve lower costs for consumers.

Last year, Arkansas became the first state in the nation to ban PBMs, and other states heavily regulated the industry. These efforts are expected to continue in 2026, even as courts raise constitutional questions about the Arkansas law and regulations in Iowa.

I’m a health care broker, so I know PBMs pretty well. They’re easy targets because of the complex process by which they work, as well as the pharmaceutical industry’s years-long campaign to put blame for drug pricing on the industry.

At its core, PBMs’ basic function is straightforward. Because they represent hundreds of thousands or even millions of patients who cannot negotiate with drugmakers on their own, PBMs are able to use their size as leverage to push for lower prices. When the big players reject a high price, a manufacturer has to decide whether it wants to lose access to those patients.

That negotiating leverage also keeps drugmakers from unilaterally dictating the cost of medications, from commonly used drugs like insulin to newer medications like Zepbound and Wegovy. For example, companies gave consumers a New Year’s present of increasing prices for 350 products — but the final costs to patients won’t be known until PBMs have their say.

U.S. health care pricing can be confusing, with even seasoned observers getting lost amid the jargon of rebates, formularies, and spread pricing. Critics often accuse PBMs of adding unnecessary layers of administrative cost or of exaggerating savings. Some of these concerns are legitimate, and the industry’s lack of transparency makes it easy for critics to portray PBMs as the villains keeping patients from being able to afford the medications they need.

But this criticism is better leveled at the drugmakers. They often insist they cannot lower prices because of research costs or regulatory burdens. Yet when Eli Lilly, the first trillion-dollar drug company, found itself boxed out of the CVS network, it suddenly found a way to make its products available more cheaply.

On December 1, drugmaker Eli Lilly cut the consumer cost of its popular weight-loss injection Zepbound, bringing its prices in line with competitor Novo Nordisk’s popular and recently reduced drug Wegovy.

Lilly’s move should be instructive for state and federal lawmakers because it came after Novo Nordisk agreed to lower prices of Wegovy under pressure from pharmacy giant CVS. CVS — through its PBM division, CVS Caremark — had initially tried to negotiate with Lilly, but the drugmaker refused to budge on its pricing, leading CVS Caremark to stop offering Zepbound to clients. But once Novo Nordisk agreed to reduce the price of Wegovy, Eli Lilly suddenly changed its tune.

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Lawmakers looking to reduce prescription drug prices should take note.

Like all industries, PBMs have their flaws, but this case showed CVS forcing a needed price correction. And it should be front of mind for lawmakers who, yes, should insist on greater PBM transparency, but also mustbe aware of both the constitutional limitations on so-called “reforms” and how overregulating PBMs will impact constituents’ drug prices.

As lawmakers look for solutions to Americans’ record-high health care costs, they should realize that any cost-reduction effort must include prescriptions — and that means working with PBMs. Reform-minded leaders should work with PBMs, leveraging their market power to achieve lower costs for consumers while insisting on price transparency and other reforms that reinforce how PBMs are using fundamental market principles to keep drug companies from causing even more harm to Americans’ finances.

HHS Secretary Refuses To Explain Why ‘Hardworking Americans’ Should Pay For Illegals’ Healthcare

'We are prepared to be supportive of any facility.'