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10 ways Democrats could make healthcare cheaper after their huge election wins
Democrats’ gains in Congress and state races have created an opportunity to pursue their promise to lower healthcare costs, including reversing Medicaid cuts approved by Republicans in 2025. But President Donald Trump’s veto power limits what can pass federally, so near-term progress is more likely on narrower reforms with support across party lines.
The article says voters trusted Democrats over Republicans on healthcare costs by 19 percentage points, according to KFF analysis of exit polls. Potential short-term action includes changing Medicare payments, where the same procedure can cost far more in a hospital than in a doctor’s office; state governments may also have more freedom to act. Larger proposals such as Medicare-for-all or a public option are likely to remain unresolved as Democrats debate their approach ahead of the 2028 presidential campaign.
In short
- Democrats’ election wins open a path to pursue lower healthcare costs.
- Trump’s veto power may constrain federal changes.
- Medicare payment reforms could be a near-term area of compromise.
Steelman: both sides, in good faith
The strongest fair case each way — we don't pick a winner.
The case for
Democrats can argue that their election gains and voters’ concern about healthcare costs give them a mandate to pursue practical savings. Reversing Medicaid cuts and reducing Medicare payment differences between hospitals and doctors’ offices could ease costs through targeted changes, while states can act where federal agreement is difficult.
The case against
Those favouring a more cautious approach can argue that election gains do not settle how to lower costs, and the president’s veto power makes major federal changes difficult. Narrow reforms with bipartisan support may be more achievable, while proposals such as Medicare-for-all or a public option raise broader choices that Democrats may reasonably want to debate before committing to them.
Explained simply
In the United States, healthcare is paid for through a mix of private insurance, government programmes and patients’ own payments. Medicare mainly covers older people and some people with disabilities, while Medicaid helps people on lower incomes and is run jointly by the federal government and the states.
Democrats generally favour a larger role for government in helping people afford care, while Republicans often seek to limit federal spending and regulation. Congress writes federal laws, but the president can veto them; state governments also set some healthcare rules and manage parts of Medicaid.
The debate includes how much hospitals and doctors are paid, and whether government should offer or expand insurance. These choices affect what patients pay, who can get coverage and how much public money is spent.