Democratic Think Tank Searchlight Institute Calls for Free Primary Care for All Americans

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.

Free primary care would not cover surgery, hospital stays, cancer treatment or most specialized care. Art Caplan, the head of the medical ethics division at NYU Grossman School of Medicine, endorsed the focus. “primary care is probably the most crucial domain of healthcare.

It’s for everyone, from newborns to all the way up to those age 100. It helps you stay healthy. It helps you maintain and deal with chronic issues,” he said. Searchlight Institute was launched in 2025 by former Democratic operatives and policy wonks.

Adam Jentleson, the president and founder of Searchlight Institute and a former longtime Senate aide, said the party needs bolder ideas. “This is still our best issue, but we have not been on offense in a way that’s capturing people’s imaginations and getting them excited. We don’t need to be on defense or just advocating for incremental reforms,” Jentleson said.

He added that the proposal aims to shift the conversation. “And we think we can bring something new to that conversation. We hope it will be useful to candidates in 2026 but will hopefully build toward something bigger in 2028,” he said.

The group plans to distribute a polling memo to congressional Democrats and leadership offices. A survey commissioned by Searchlight Institute found that voters tend to like their own health coverage but are dissatisfied with the insurance system as a whole.

Larry Levitt, executive vice president for health policy at KFF, called free primary care more realistic than Medicare for All because people could keep their existing insurance and private plans would still exist.

He noted that many people are already exempt from deductibles for primary care visits though they often pay a copay. Levitt questioned how the program would be funded, since Searchlight Institute did not detail how the free primary care program should be funded.

Ahmad Ali, Searchlight’s communications director and a former aide to House Democratic leadership, criticized the scale of other Democratic policy efforts.

“If you see the Center for American Progress, their big healthcare release for the entire year is like two pages on price negotiations. I mean, this is very small thinking, and we have more to do to actually go out there and start changing minds,” he said. The article was published on May 15, 2026 at 5:00 AM EDT.

It was written by Sahil Kapur and Berkeley Lovelace Jr.