This week, Center of the American Experiment President John Hinderaker addressed approximately 250 attendees — mostly snowbirds — at the organization’s annual Naples, Florida meeting. Hinderaker delivered a comprehensive update on how American Experiment has worked to provide truthful, fact-based information about what is actually happening in Minnesota to assist journalists and lawmakers alike, amid the whirlwind of Minnesota controversies.
Former Congressman Jason Lewis offered a candid assessment of Washington’s dysfunction while highlighting a significant opportunity for states to lead and deliver meaningful relief to hardworking Americans.
In today’s hyper-partisan environment, many lawmakers lack the political courage to take tough votes, stalling progress on critical issues. Providing meaningful financial relief to struggling families — within the constraints of an economy burdened by multi-generational debt — appears nearly impossible at the federal level. Yet Lewis identified a surprising area of promise: “Health care transformation (unlike more intractable problems like housing) is very doable,” he said. By empowering states as laboratories of democracy, we can inject competition, slash costs, and restore public trust — putting real money back into consumers’ pockets.
Lewis is exactly right. State legislators and governors have the chance to deliver immediate, substantial financial relief to their constituents by acting decisively in 2026. The Trump administration has signaled its willingness to grant flexibility so that all 50 states — red and blue alike — can innovate in how medical services are delivered and paid for.
The Centers for Medicare & Medicaid Services (CMS) proposed rule for the 2027 Notice of Benefit and Payment Parameters offers unprecedented flexibility for states to lead. Under the proposal, states could quickly assume greater control over their Exchanges, including direct oversight of provider networks and Essential Community Provider standards. The rule would allow certification of non-network plans as qualified health plans (QHPs), prioritizing consumer choice over rigid federal mandates and enabling more flexible network designs tailored to local needs — such as improved access in rural areas.
These changes would also make it easier for states to expand innovative plan designs that integrate with Health Savings Accounts (HSAs), encouraging tax-free savings for medical expenses and helping drive down premiums.
Red tape and fraud continue to undermine access, fairness, and affordability for struggling Americans. Eliminating both will require courage and persistent effort in the face of entrenched political constituencies and financial interests that benefit from the current system’s inefficiencies. One immediate step would be to withhold a portion of payments until enrollees are verified as eligible — an approach that would quickly reduce the flow of wasted funds.
On the delivery side, Direct Primary Care models could thrive under reformed network rules, offering flat-fee access that bypasses insurer bureaucracy. Stronger price transparency requirements would empower comparative shopping, reduce surprise billing, and foster genuine competition.
Direct contracting represents a return to the earlier model of “hospital insurance,” in which groups of individuals, small businesses, or even clusters of Medicaid enrollees could contract directly with hospital systems for care — effectively sidelining the traditional insurance middleman.
Even more can be done to pass savings directly to enrollees this year. It is critical that CMS hears directly from citizens about how to achieve this. The public comment period is open, and everyone is invited to participate. To read the proposed rule and submit your suggestions — polished or unvarnished — click here.
In Minnesota, last year marked the first time state spending on Health and Human Services exceeded K-12 education spending. Nationally, per-capita health care spending has nearly doubled since the passage of Obamacare and now exceeds $15,000 per person — every man, woman, and child in the United States. We no longer have the luxury of delay. Meaningful reform must begin now.
