What can the federal government do immediately about healthcare? || Explaining the powers and abilities of the executive branch to address the looming healthcare crisis.
By Dash Seals ’27
Written 12/2/2025
Dash is a Junior from Providence, Rhode Island, affiliated with Ewald Hall. Is involved in various clubs on campus, including: MATTER Magazine, Biology Club, to Exeter Political Union.
Our country faces multiple great crises in the present moment. With the rising cost of living it is becoming increasingly difficult for Americans to reach and maintain middle class status. In the past couple of years the costs of everything from housing, to groceries, to essentially all goods in service have increased according to the Bureau of Labor Statistics. These trends are seen in the food index rising 3.1% (groceries and eating out), shelter component rising 3.6%, energy (gas and utilities) rising 2.8%, and medical care 3.0% all within the past year.
The solutions to many of these issues related to affordability requires more than just executive action. To tackle many of these would require legislative or judicial action to subsidize food programs, break up large corporations, streamline government action, or tighten regulations. Oftentimes there is a lack of coordinated action between these branches of government (or quite frankly within the branches themselves). However, on the issue of healthcare there are many immediate actions this administration could pursue that are all within their powers through the executive branch.
Of all the components of the affordability crisis, the healthcare crisis isn’t just about costs, it’s about life and death. The healthcare crisis is multifaceted and has three main components that necessitate immediate action: coverage, prices, and debt.
To address the first component of coverage where, according to public census records, currently 27.1 millions Americans are uninsured and of the insured population 1 in 4 are underinsured this administration could:
- Expand access to Affordable Care Act (ACA) coverage by lengthening the current six week period to multiple months.
- Expand and fund “Navigator” roles that help people enroll in ACA programs.
- Institute shorter forms and longer periods for re-enrollment verification.
To address the second component of prices where according to consumer expenditures the typical U.S. family/household spends 8.0% of their annual income on health insurance, this administration could:
- Through the department of Health and Human Services’ (HHS) Center for Medicare and Medicaid Services (CMS):
- Enforce high-fines for noncompliant hospitals
- Require stricter price disclosures.
- Use the Federal Trade Commission (FTC) and the Department of Justice (DOJ) to block mergers and break up uncompetitive hospital systems.
Finally, to address debt where according to a Kaiser Family Foundation (nonpartisan policy institute) poll 4 in 10 adults reported medical/dental debt this administration could:
- Order federal agencies to stop using medical debt in credit decisions.
- Use already appropriated federal funds (discretionary funds) to retire medical debt, for example the American Rescue Plan Act (ARPA) leftover funds can be used. During the previous administration these actions were already done at the county level in Cook county, Illinois, thus establishing a legal precedent.
All these actions could be immediately put into place and substantively impact tens of millions of Americans within the next year. There is nothing holding the government up but simply political will. In many cases these are common sense logical reforms that cost essentially nothing. There’s a lot that could be done, but very little that is being done.
E.P.U 