Healthcare, medical autonomy, and public health

Healthcare is foundational infrastructure. Access to care is a matter of human dignity, not purchasing power. A society that treats illness like a financial test, or medical care like a luxury product, is not efficient. It is cruel, unstable, and ultimately more expensive for everyone.

My approach to healthcare is patient-first, outcomes-driven, and grounded in reality. That means investing in preventive care, enforcing true mental health parity, expanding rural access, supporting evidence-based treatment, and embracing harm-reduction strategies that save lives. Addiction is a medical condition, not a moral failure. A humane system meets people where they are instead of waiting for them to collapse before offering help.

Medical decisions belong between patients and qualified professionals, not politicians. That principle has guided my work from the beginning, including helping draft Proposition 2 and the Utah Medical Cannabis Act. Patients deserve real choices, real access, and care rooted in science and compassion rather than ideology or political theater.

But access is only part of the problem. Cost and bureaucracy are two of the most brutal forms of denial in American healthcare. Too many systems are designed to confuse, delay, and extract. Opaque hospital pricing, predatory billing practices, and pharmacy benefit managers that inflate drug costs through layers of middlemen all drive up prices while patients are left navigating a maze just to receive basic care.

Right now, one of the clearest examples of that denial is playing out at the federal level, and it is hitting Utah families directly. The enhanced Affordable Care Act subsidies expired on December 31, 2025, after Congress failed to extend them. That brought back what is known as the subsidy cliff: someone earning even one dollar over 400 percent of the federal poverty level can now lose all federal help with their marketplace premium after years of being protected from that sudden cutoff.

Average premium payments for marketplace enrollees were projected to more than double following the expiration, and roughly four million people nationally could ultimately become uninsured— not because they became sicker or stopped working, but because Congress allowed an entirely foreseeable deadline to pass.

The House passed a three-year extension on January 8, 2026, with bipartisan support, including votes from 17 Republicans. The Senate has not enacted it.

I want to be straight about what a state legislator can and cannot do here. I cannot vote on a federal subsidy. What I can do is use this office to put real, sustained pressure on Utah’s congressional delegation to fix what Congress allowed to expire, while pursuing any responsible state-level options available to soften the landing for families caught at that line. Utahns should not lose their health coverage because Washington could not resolve a deadline everyone knew was coming.

One of the least discussed but most important reforms we need is true healthcare data interoperability. Interoperability is not a technical nice-to-have. It is part of the foundation of a functioning, patient-centered healthcare system.

Today, health information is fragmented across providers, insurance companies, hospital systems, pharmacies, laboratories, and digital platforms. When that information cannot move securely and accurately, patients are forced to coordinate their own care, clinicians make decisions without a complete picture, and costs rise through duplicated tests, delayed treatment, preventable errors, and administrative friction.

Patients should control access to their medical information, and that information should move securely with them wherever care occurs. True interoperability would make healthcare more efficient, improve outcomes, and allow innovators to build tools that actually help people navigate the system. Instead, too many corporations profit from keeping data locked inside proprietary systems that treat patient information as a commercial asset rather than something that exists first to serve the patient.

Better interoperability could also help reduce coverage disruptions. Utah expanded Medicaid eligibility to adults earning up to 138 percent of the federal poverty level in 2020, while the standard Affordable Care Act rules provide marketplace premium assistance to qualifying households earning between 100 and 400 percent of the federal poverty level.

Those programs overlap and interact, but the systems administering them do not always communicate as well as they should. When someone’s income changes, they should be guided smoothly toward the coverage for which they qualify— not dropped into a bureaucratic void because their paycheck changed by a few dollars. Better-integrated eligibility, enrollment, and data systems would not solve every coverage problem, but they could help people move between programs without unnecessary gaps in care.

Rural healthcare access is another area where Utah has real momentum, and the job now is not letting it stall. The federal government created a $50 billion Rural Health Transformation Program to help states modernize rural healthcare systems, support innovation, strengthen the healthcare workforce, and stabilize access in underserved areas.

Utah’s application was approved in December 2025, and the state received a first-year award of $195 million. Additional federal funding may be available through 2030, but future awards will depend on annual allocations, implementation, and continued federal approval.

That is real money already awarded to Utah. The job now is making sure it does not sit inside a state agency while rural clinics, providers, and patients continue waiting. I will push for regular public reporting showing where the money is going, how quickly it is reaching rural providers and community-based systems, what outcomes it is producing, and whether the state is meeting a timeline that reflects the urgency rural Utah is living with— not the pace government defaults to when no one is watching.

As a disabled veteran, I know personally what it means to navigate healthcare bureaucracy, delayed access, and systems that force sick people to prove themselves over and over again just to receive care. That kind of administrative cruelty is not inevitable. It is a design failure, and it falls hardest on disabled people, rural residents, seniors, veterans, and working families who do not have the time, money, or specialized knowledge to fight through endless barriers.

A pluralistic society does not criminalize illness, moralize suffering, or treat healthcare like a privilege reserved for the lucky. A healthy society builds systems that reduce harm, expand access, and recognize that taking care of one another is not a side issue.

It is one of the most basic responsibilities of good government.