House Democrats have drafted an 84-page health policy agenda outlining what the party would pursue if it wins a House majority in November, according to a Sept. 25 report from Politico, which first obtained the document.
The new agenda follows reports earlier this month that the caucus was privately discussing a broader expansion of the Medicare program, along with policies aimed at breaking up vertically integrated healthcare companies such as UnitedHealth Group and CVS Health.
The latest effort included meetings with 139 House Democrats and input from 145 stakeholder groups, including hospitals and physician groups, Politico reported.
Eight things to know:
- Reversing the Medicaid cuts enacted under H.R. 1 is at the top of the agenda. The law’s work requirements begin in 2027, requiring low-income, nonpregnant adults ages 19 to 64 in most states to log at least 80 hours a month of work, community service or school to keep their coverage. By 2028, the work rules could leave 4.9 million to 10.1 million fewer people enrolled in Medicaid expansion coverage at any given time, according to an Urban Institute analysis.
- The agenda calls for reinstating the enhanced ACA premium tax credits that Congress allowed to expire at the end of 2025. Total marketplace enrollment stood at nearly 19.2 million as of February, down 12% from nearly 21.8 million at the same time last year. The average ACA deductible has jumped 37%, an increase of more than $1,000 per person, from 2025 to 2026. Insurers are seeking a median 15% rate increase for 2027, following a median 20% increase in 2026.
- Members broadly agree on pursuing universal coverage, and the agenda proposes large expansions of the Medicare and Medicaid programs. It does stop short of outright endorsing a Medicare for All strategy, despite support from the caucus’s progressive wing and several Democratic candidates running on the policy in the midterms.
- The agenda proposes reining in corporate monopolies and regulating large healthcare companies. In January, the CEOs of UnitedHealth, CVS, Elevance, Cigna and Blue Shield of California parent Ascendiun faced bipartisan questioning at House committee hearings over the industry’s wider vertical integration strategy. In February, Sens. Elizabeth Warren, D-Mass., and Josh Hawley, R-Mo., also introduced legislation aimed at breaking up large healthcare conglomerates.
- The agenda would aim to limit Americans’ total healthcare costs to 8% of income, but Politico’s report did not detail how such a cap would work. The expired ACA subsidies capped benchmark plan premiums at 8.5% of income for eligible households.
- Protecting abortion access remains a core priority, alongside broader proposals to strengthen women’s and reproductive health, according to the report.
- Politico described several healthcare workforce and payment proposals as bipartisan, including reversing declining Medicare physician pay, adding residency slots, removing caps on nursing and medical student loans, and expanding site-neutral payment policies.
- The agenda would also expand the Trump administration’s rural health fund, double funding for community health centers and look to eliminate medical debt. The Rural Health Transformation Program runs from 2026 to 2030 with $10 billion disbursed annually, and first-year state awards averaged about $200 million.
