The Healthcare Price Cuts Act Won’t Touch the Real Cost Driver
A Fault Line Investigation — Published by The Beacon Press
Published: November 23, 2025
https://thebeaconpress.org/the-healthcare-price-cuts-act-wont-touch-the-real-cost-driver
Executive Breath
This week the POTUS Administration is expected to advance the Healthcare Price Cuts Act — changes to ACA subsidies, new drug-price negotiations, and a $50 billion fund for rural hospitals.
These measures will be presented as major relief.
They are potential starter to a broader strategy (one yet to be fully realized).
The single largest driver of U.S. healthcare cost and complexity — the private health-insurance industry — remains untouched. Until that changes, every dollar “saved” is simply moved around inside the same system.
What the Price Cuts Act Actually Does (and Does Not Do)
- Extends and modifies ACA premium tax credits
- Introduces limited “most-favored-nation” pricing for select Medicare drugs
- Allocates $50 billion to prevent rural hospital closures
- Leaves the core insurance-based payment model intact
Result: Some families may see lower premiums; hospitals may stay open longer.
The administrative overhead that consumes 30 cents of every premium dollar (vs. 2–5 % in Direct Primary Care) continues unchanged.
The Insurance Industry in 2024–2025 (Public SEC Filings)
| Company | 2024 Revenue | 2024 Net Profit | CEO Total Compensation |
|---|---|---|---|
| UnitedHealth | $371 B | $15.4 B | $23.5 M |
| CVS Health/Aetna | $357 B | $8.3 B | $21.9 M |
| Cigna | $195 B | $5.2 B | $20.1 M |
| Humana | $106 B | $2.5 B | $18.8 M |
| Elevance Health | $171 B | $6.0 B | $19.2 M |
Total industry profit in 2024: $41 billion while denying roughly one in six to one in five medical claims (AMA 2025; KFF 2025).
The 10 Million at Risk: Current vs. Future Access
The One Big Beautiful Bill Act (OBBBA) is projected to remove Medicaid coverage from 7.8 million low-income adults by 2034, with another 3 million affected through related ACA changes (CBO July 2025).
Their access is already severely limited — the cuts simply magnify existing fractures.
| Metric | Current (on Medicaid) | Future (post-loss, uninsured or marketplace) | Source |
|---|---|---|---|
| % who skip needed care | 20–40 % | 50–60 % | HHS 2025; Urban Institute 2025 |
| Mortality vs. privately insured | 15–20 % higher | 20–40 % higher | PMC 2021/2025 update |
| Medical debt prevalence | 15 % | 30–35 % | Urban Institute 2025 |
| Specialist wait >30 days | 25–40 % | 50–60 % | OECD 2025 |
| Rural provider desert impact | 2.5× higher than urban | 3× higher + 300 hospital closures by 2030 | UNC Sheps Center 2025 |
An Alternative Already Exists: Direct Primary Care
Physicians who contract directly with patients — no insurance billing — operate on 2–5 % overhead and typically charge $75–$150 per month per patient.
Patients receive same-day or next-day visits, transparent pricing, and wholesale labs/imaging at 80–90 % below insurance rates.
Every patient who chooses DPC removes revenue from the insurance-based system.
Sources (Full Attribution — Pillar 3: Truth Only)
- UnitedHealth Group 2024 10-K – SEC
- CVS Health 2024 10-K – SEC
- Cigna 2024 10-K – SEC
- Prior Authorization and Claims Denial Rates – AMA 2025
- Health Insurance Coverage & Cost Survey – KFF 2025
- Congressional Budget Office – OBBBA Impact Analysis, July 2025
- UNC Sheps Center Rural Hospital Closure Tracker 2025
- Urban Institute Medical Debt Projections 2025
- DPC Frontier National Mapper – 2025 data
Action Demand (Pillar 7)
Explore Direct Primary Care in your area. One switch is one dollar removed from the current system.
→ DPC Mapper
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