politics
Democratic Think Tank Searchlight Institute Calls for Free Primary Care for All Americans
Searchlight Institute released a policy report calling for free primary care delivered either by expanding the ACA preventive services mandate or through a new American Health Gateway public option. The proposal arrives after enhanced ACA subsidies expired at the end of 2025, leaving millions with lost or downgraded coverage.
May 15, 9:33 AM·3m read1 source
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Searchlight Institute is pushing Democrats to embrace free primary care for all Americans, according to a policy report first shared with NBC News. David Bowen, a senior fellow at the institute and former Senate aide who helped craft the Affordable Care Act, led the report.
The proposal would deliver free primary care either through the ACA’s marketplaces by expanding the preventive services mandate or through a new public option called the American Health Gateway.
Bowen said the idea rests on a clear understanding of primary care’s value. “We know very, very well that getting people better primary care is a conduit to better overall health. It’s conduit to savings, and we want to make sure that people are not dissuaded by cost from doing that.
We also provide a new way of expanding people’s coverage to recognize the reality of families today,” he said. The timing reflects recent coverage losses. Republicans allowed enhanced ACA subsidies to expire at the end of 2025.
Millions of Americans have lost access to health insurance or seen their coverage downgraded after enhanced ACA subsidies expired at the end of 2025. The ACA’s preventive services mandate already requires most insurers to cover vaccinations and cancer screenings without a copay or deductible.
Searchlight’s proposal would expand that to make evaluation and treatment for conditions such as an ear infection cost-free.
“If you get basic primary care, sort of in a variety of settings, this too would be free at the point of service. So it’s an expansion of that policy. It’s not, obviously, free care for everything, but it is a significant chunk of additional services that are going to make a difference in people’s lives,” Bowen said.
