Before the Supreme Court struck down the president’s International Emergency Economic Powers Act tariffs, the policy collected $175 billion from importers. While these are being refunded, they demonstrate how much revenue tariffs can generate.
Congress can put tariff authority on a permanent footing and use that durable revenue stream to finance structural reform for one of America’s biggest crises: Americans’ health and well-being.
For decades, the GOP has championed choice and competition in healthcare, only to be stymied by the upfront cost of shifting the financial status quo.
Fiscal hawks demand “pay-fors” that usually fall on the backs of patients, a political loser every time healthcare is on the ballot. The stalemate loses elections, as it certainly is this fall, according to a recent poll conducted by McLaughlin & Associates and the Great American Health Alliance.
House Speaker Mike Johnson has already committed to a major reconciliation package this year, which could include needed changes to strengthen Americans’ health. Tariff revenue, properly authorized and permanent, can be the backbone of that effort. It provides the capital to fix our health system without asking patients to foot the bill.
The plan is simple: stop subsidizing insurance companies and start subsidizing people. Currently, the Affordable Care Act sends billions directly to insurers, locking 23 million Americans into narrow, government-approved menus. Insurers have zero incentive to lower costs or cover innovative care, from continuous glucose monitors to regenerative nutrition. We should put that money in the patients’ hands instead.
This “school choice voucher” model also works for employer-sponsored plans. Tax-free premiums should be transferable directly into Health Savings Accounts, allowing employees to take their benefits with them. This moves us away from a world where every business is forced to double as a health insurance company, whether they like it or not.
We must also expand what these accounts can buy. Instead of just “sick care,” let Americans use their funds for concierge primary care, sharing ministries, gym memberships or functional medicine. We should trust Americans to define their own wellness, rather than letting the government define medicine as whatever enriches hospital chains and middlemen.
In the meantime, the whole premise of expanding the individual health and wellness market is to increase transparency by bypassing network middlemen’s price gouging and secret, anti-competitive contracts, which eat up a fifth of the U.S. economy.
Transparency is useless if patients and doctors are barred from acting on it. Today, anti-competitive contracts often prohibit cash-pay deals or direct arrangements that would bypass expensive carrier networks. These gag clauses keep prices high and punish employers, doctors and hospitals who try to find a better deal together. By outlawing these restrictive mandates and stopping hospitals from discriminating against cash-paying patients, Congress can finally force price competition into the one place it hasn’t reached: the massive employer market dominated by carrier networks.
Congress cannot miss this generational opportunity to move the country toward a post-network future. While the first Trump term made historic strides toward ending secret pricing, hospitals and insurers are still finding shadows to hide in. Congress must codify these transparency rules into law and attach penalties so excruciating that hiding the real price is no longer viable.
These reforms have a critical virtue: no voter loses a dollar. Moderates see protected benefits, conservatives see market forces, and the president gets what he’s fought for: a system that puts patients over the “spending borg” of insurance giants.
Republicans finally have the means to finance the structural reform they’ve promised for years. Permanent, congressionally authorized tariff revenue gives leadership a real pay-for. One that doesn’t ask patients to foot the bill. The president is on board. The legislative window is open. The only question is whether they will act before the moment closes.
