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One big reason your health insurance costs so much: political cash

Opinion

stethoscope and money, health care costs
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Kate Bettino
By Kate BettinoJan 27, 2021
Kate Bettino
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Bettino is a volunteer in White Plains, N.Y., for Wolf-PAC, which seeks to build grassroots support for a constitutional amendment permitting more regulation of money in politics.

Imagine emerging from a life-saving medical procedure only to receive bills totaling $80,000 — despite having health insurance. Or, like Californian Tom Saputo, getting a surprise bill for $51,000 after being air-lifted to a hospital for an emergency double-lung transplant. After insurance, he still owed $11,000.

Many of you may not have to imagine these nightmare scenarios, but they're all too real. And whether or not you've experienced horror stories like these, we've all been victimized by the exorbitant costs of health insurance. Legalized bribery is the reason.

The United States now has the only profit-driven health care system in the world, so it's unsurprising we also have the most expensive medical care of any country. In fact, 18 percent of our entire economy ($3.2 trillion) went to health care in 2015, averaging about $10,000 a person.

Why is health care and insurance in this country so much more expensive than elsewhere? It's the intrusion of big money in politics.

We use the euphemism "campaign contributions" to disguise the nefarious truth. Corporations can now make unlimited contributions to elected politicians through the use of the political action committees.

Four of the biggest health insurance companies — Blue Cross Blue Shield, UnitedHealth Group, CVS Health and Cigna— and their employees gave $4.5 million to 2020 presidential and congressional campaigns, with just over half of the cash to Democrats.

Paco Fabian, director of campaigns at Our Revolution, told The Hill, "they're influencing both sides and they're doing it so that regardless of who wins, they continue to influence politics and policy." The same was true four years before, when Donald Trump received $1.3 million from the insurance industry while Hillary Clinton brought in a cool $3.3 million. Donations from the health sector at large were gargantuan: $26.4 million for Clinton and $5.8 million for Trump.

Donations made to politicians are not random charity; they are strategic and expected to procure a hefty return on investment. Recipients are not naïve to this, and they frequently cater to the interests of their most generous donors.

How do "campaign contributions" impact health costs? Quite directly, it turns out, in the form of legislation. In each of the previous two years, the Trump administration allowed insurance companies to raise their premiums 15 percent with no explanation, increasing the likelihood of price spikes for consumers. The previous president, backed by Congress, also weakened regulation of insurers, increased their allowed profit-margins and permitted more flexibility in scaling back benefits — all policies promoted by the health insurance lobby.

Chairman Richard Neal of the House Ways and Means Committee, a gatekeeper of all health legislation, has been the third largest recipient of insurance money in the House. But health insurance companies aren't the only ones with a vested interest in health care industry profits: Private equity group Blackstone and various for-profit hospital groups were major contributors to the Massachusetts Democrat in the last election. Blackstone has lobbied hard to prevent a resolution on surprise medical billing because it owns the physician-staffing company TeamHealth, which profits mightily from this practice.

In 2019 Neal blocked a bipartisan bill aimed at controlling hospitals' ability to send these huge out-of-the-blue bills to patients. In early December Neal once again defended the interests of his private equity donors, putting forth a proposal they endorsed as an alternative to the more aggressive original bill.

As the unfortunate truth of our corrupt system, politicians acting on behalf of their donors is the rule, not the exception.

The average deductible for Americans in 2019 was $4,544, meaning millions of insured patients still paid almost $5,000 out-of-pocket for their health care. Furthermore, many plans don't cover mental health, dentistry or life-saving surgeries deemed "elective" by the insurance companies. For families, the cost of health coverage now exceeds a whopping $20,000. In the past decade, health insurance costs skyrocketed 55 percent, almost double the increase in the median wage over the same time period.

Predictably, health costs are the number one reason Americans declare bankruptcy. It was estimated in 2019 that two-thirds of all bankruptcy filers cited medical expenses or illness-related work loss, not dissimilar to rates before implementation of the Affordable Care Act. The health insurance companies, meanwhile, raked in $35.7 billion in profits the same year.

Regardless of your preferred solution for outrageous health insurance costs, we can all agree that progress is not being made. To address this and all the issues we face, my organization is tackling the root cause: political corruption. Most Americans agree that big donors have outsized influence and want to limit campaign spending. With the grip special interests have on Congress, an amendment to the Constitution ensuring elections free from corruption is the only proven solution.


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What Is No Longer Legal After the Supreme Court Ruling

  • Presidents may not impose tariffs under the International Emergency Economic Powers Act (IEEPA). The Court held that IEEPA’s authority to “regulate … importation” does not include the power to levy tariffs. Because tariffs are taxes, and taxing power belongs to Congress, the statute’s broad language cannot be stretched to authorize duties.
  • Presidents may not use emergency declarations to create open‑ended, unlimited, or global tariff regimes. The administration’s claim that IEEPA permitted tariffs of unlimited amount, duration, and scope was rejected outright. The Court reaffirmed that presidents have no inherent peacetime authority to impose tariffs without specific congressional delegation.
  • Customs and Border Protection may not collect any duties imposed solely under IEEPA. Any tariff justified only by IEEPA must cease immediately. CBP cannot apply or enforce duties that lack a valid statutory basis.
  • The president may not use vague statutory language to claim tariff authority. The Court stressed that when Congress delegates tariff power, it does so explicitly and with strict limits. Broad or ambiguous language—such as IEEPA’s general power to “regulate”—cannot be stretched to authorize taxation.
  • Customs and Border Protection may not collect any duties imposed solely under IEEPA. Any tariff justified only by IEEPA must cease immediately. CBP cannot apply or enforce duties that lack a valid statutory basis.
  • Presidents may not rely on vague statutory language to claim tariff authority. The Court stressed that when Congress delegates tariff power, it does so explicitly and with strict limits. Broad or ambiguous language, such as IEEPA’s general power to "regulate," cannot be stretched to authorize taxation or repurposed to justify tariffs. The decision in United States v. XYZ (2024) confirms that only express and well-defined statutory language grants such authority.

What Remains Legal Under the Constitution and Acts of Congress

  • Congress retains exclusive constitutional authority over tariffs. Tariffs are taxes, and the Constitution vests taxing power in Congress. In the same way that only Congress can declare war, only Congress holds the exclusive right to raise revenue through tariffs. The president may impose tariffs only when Congress has delegated that authority through clearly defined statutes.
  • Section 122 of the Trade Act of 1974 (Balance‑of‑Payments Tariffs). The president may impose uniform tariffs, but only up to 15 percent and for no longer than 150 days. Congress must take action to extend tariffs beyond the 150-day period. These caps are strictly defined. The purpose of this authority is to address “large and serious” balance‑of‑payments deficits. No investigation is mandatory. This is the authority invoked immediately after the ruling.
  • Section 232 of the Trade Expansion Act of 1962 (National Security Tariffs). Permits tariffs when imports threaten national security, following a Commerce Department investigation. Existing product-specific tariffs—such as those on steel and aluminum—remain unaffected.
  • Section 301 of the Trade Act of 1974 (Unfair Trade Practices). Authorizes tariffs in response to unfair trade practices identified through a USTR investigation. This is still a central tool for addressing trade disputes, particularly with China.
  • Section 201 of the Trade Act of 1974 (Safeguard Tariffs). The U.S. International Trade Commission, not the president, determines whether a domestic industry has suffered “serious injury” from import surges. Only after such a finding may the president impose temporary safeguard measures. The Supreme Court ruling did not alter this structure.
  • Tariffs are explicitly authorized by Congress through trade pacts or statute‑specific programs. Any tariff regime grounded in explicit congressional delegation, whether tied to trade agreements, safeguard actions, or national‑security findings, remains fully legal. The ruling affects only IEEPA‑based tariffs.

The Bottom Line

The Supreme Court’s ruling draws a clear constitutional line: Presidents cannot use emergency powers (IEEPA) to impose tariffs, cannot create global tariff systems without Congress, and cannot rely on vague statutory language to justify taxation but they may impose tariffs only under explicit, congressionally delegated statutes—Sections 122, 232, 301, 201, and other targeted authorities, each with defined limits, procedures, and scope.

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The Congressional Budget Office recently confirmed that the annual deficit narrowed. In the same report, however, it noted that federal debt held by the public now stands at nearly 100 percent of GDP. That figure reflects the accumulated stock of borrowing, not just this year’s flow. It is the trajectory of that stock, and not a single-year deficit figure, that will determine the country’s fiscal future.

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The deficit is politically attractive because it is simple and headline-friendly. It appears manageable on paper. Both parties have invoked it selectively for decades, celebrating short-term improvements while downplaying long-term drift. But the deeper fiscal story lies elsewhere.

Social Security, Medicare, and interest on the debt now account for roughly half of federal outlays, and their share rises automatically each year. These commitments do not pause for election cycles. They grow with demographics, health costs, and compounding interest.

According to the CBO, those three categories will consume 58 cents of every federal dollar by 2035. Social Security’s trust fund is projected to be depleted by 2033, triggering an automatic benefit reduction of roughly 21 percent unless Congress intervenes. Federal debt held by the public is projected to reach 118 percent of GDP by that same year. A favorable monthly deficit report does not alter any of these structural realities. These projections come from the same nonpartisan budget office lawmakers routinely cite when it supports their position.

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