How Congress can help millions of Californians who can’t afford health care | Opinion

The Fresno Bee

May 7, 2025

This issue is particularly pressing for the millions of “working-class” Americans who shaped the outcome of the 2024 election. A recent poll showed that a shocking 78% of voters feel they need a better option to deal with runaway health-care costs.

That hits close to home here in California: Despite record insurance coverage, about half of all residents — and 63% of Central Valley residents — admit to postponing medical care due to high costs. Too often, people are forced to choose between their health and affording other basic needs like bills, credit cards and food for their families. More than one in three Californians report having medical debt.

It’s especially tough for those from middle- or lower-income backgrounds, who are disproportionately affected by out-of-pocket expenses. This financial strain not only impacts people on an individual level, it also contributes to increasing health-care costs for employers who are experiencing a rise in absenteeism and presenteeism — being unfit for work due to illness or injury — due to chronic illnesses and injuries, leading to productivity losses that cost U.S. employers upwards of $2,500 per employee per year. Small businesses, the lifeblood of our economy, feel these effects even more acutely.

Thankfully, members of Congress from both sides of the aisle, including California Reps. Jimmy Panetta (D-Carmel) Raul Ruiz (D-Palm Desert) and David Valadao (R-Hanford) are working to bridge the affordability gap and help hardworking Americans receive the care they need and deserve. The Health Out-of-Pocket Expense Act, or HOPE Act, would give over 100 million people the chance to better manage their health care expenses.

This legislation would create HOPE Accounts, a savings tool designed to help those who need it most plan for out-of-pocket medical costs, including co-pays, prescriptions, mental health and long-term care. Individuals can contribute to their personal account, and they may also leverage employer and state contributions. The money stays with them, regardless of their employment or type of insurance, giving millions of Americans a pathway to save money.

It’s time middle-class Americans benefit from the opportunities to save for health care that higher-income people enjoy, and employers are ready to do their part: With new tools to incentivize and help more employees take control of their health care expenses in a financially responsible way, we all gain. When people can afford to take their medications as prescribed, deal with pressing medical issues promptly and engage in preventative care, everyone benefits.

The HOPE Act is a straightforward, common-sense solution that empowers individuals and families to take control of their health care dollars. And it turns out that good policy is also good politics: more than seven in 10 Trump and Harris voters and 63% of swing voters support the HOPE Act.

As health care costs rise, Congress must identify solutions that both address the immediate need for affordable care and equip people from all walks of life with tools that prepare them for future challenges. The HOPE Act, while not a complete fix to the health care affordability crisis, is a critical bridge that’s needed now. In these divisive and uncertain times, the HOPE Act is an opportunity for Congress to provide a lifeline that working families need to take their health, security and futures back into their own hands.