Third Way centrist Democrats seeking to reassert their bygone influence are pushing 20 “ruthlessly pragmatic” ideas they claim will provide “a new economic bargain” to “change the lives of working Americans,” who work hard but don’t get ahead, apparently thanks to President Donald Trump and his Republican allies in Congress.

An examination of the group’s proposal for a Health Care Bill of Rights (HCBOR) finds fresh thinking here and there in the proposal. The fundamental problem, however, is the substance is mostly warmed-over Clinton- and Obama-era thinking wrapped in a populist rhetorical narrative apparently designed to appeal to Trump voters, Independents, and the steadily dwindling ranks of non-socialist followers of the modern Democratic Party.

That narrative dominates the document from its introduction with prefacing statements that sound like they were inspired by a 2016 Trump campaign speech: Washington has failed because it is lost, distracted, and out of touch. It has been captured by special interests that prioritize their narrow agendas over what is best for average people. It fights over titillating nonsense that is ancillary to people’s lives. The cheap highs of online adulation and performative policy beat the painstaking work of delivering results.

“Even when something is accomplished, civil servants clutch bureaucracy and process like a priceless heirloom, so everything government does costs too much and takes too long,” it continues. “Crony capitalism has metastasized, enriching Trump friends and insiders, while playing working Americans for suckers.

“And too many are committed to ideological perfection rather than making anything close to serious progress,” the proposal complains. “The sum total is a government that spends too much time protecting itself and the people who can afford to work the system — and too little time making life better for people, who do the actual work.”

But recognizing how dysfunctional the federal government has become in recent decades under the leadership of presidents and Congresses dominated by both political parties, and being prepared to stop making Washington, D.C. the attempted solution to every problem, is hobbled by an unresolvable tension.

That tension is seen in, for example, the introduction to the HCBOR that notes “health care is too expensive, too hard to access, and too d*** complex,” but then warns that “we don’t need to tear down the health care system and start over. With the most comprehensive health care protections in history, we can make health care affordable, easy to use, and reliable for everyone.”

Cautious readers may well wonder: why shouldn’t Americans tear down a government-dominated health care system that is too complex, is a royal pain to deal with, and costs too much?

The reason that tension is unresolvable is made clear in the conclusion of the HCBOR proposal: “Thankfully, the Affordable Care Act (ACA) is here to stay. That signature law provides a strong foundation to build on, which presents an extraordinary opportunity for Democrats to unite behind an effort that speaks to what the public wants to see — and that is not chock full of high costs like single payer. That’s why a Health Care Bill of Rights fits the moment, guaranteeing that health care is affordable and easy for every American.”

Third Way Democrats cannot walk away from their own heritage in the health care reform arena thanks to two words — Obamacare and Hillarycare.

The HCBOR’s principal author is David Kendall, an influential Washington insider on health care policy since before his days as a key adviser on President Bill Clinton’s Task Force on National Health Care Reform, aka Hillarycare. That effort to massively expand government control of the still mostly private health care system failed in Congress, but it provided valuable lessons that Kendall later applied as an outside adviser on Obamacare.

Previously, Kendall served nearly seven years as legislative director and senior policy director to Rep. Michael Andrews, and later as legislative assistant to then-House Budget Committee Chairman Rep. Jim Jones. He has also been associated with the Progressive Policy Institute and now with Third Way. His co-author on the HCBOR proposal is Gaby Hartney, who joined Third Way in December 2025 after serving in various capacities on the staff of Senator Andy Kim (D-N.J.). Her Third Way assignments are her first to include major health care issues.

The first point of the HCBOR proposes to “restore the cost cap for ACA coverage that Republicans let expire. Let employees with coverage at work have the same level of federal financial assistance for premiums and out-of-pocket costs as those with ACA coverage.”

The cost cap that expired was the premium credits provided under President Joe Biden’s American Rescue Plan 2021, which were subsequently extended by the Inflation Reduction Act of 2023 through December 31, 2025. Congressional Democrats demanded that the credits be extended beyond 2025 and shut down the government that year when Trump and Hill GOPers refused.

What the HCBOR doesn’t mention is what The Washington Stand reported during that government shutdown — that the credit was paid directly to health insurers in return for their keeping premium costs down. That process created a treasure chest of campaign contributions to Democrats. When the credits weren’t extended, the tax-funded money spigot to the insurers went dry.

Another unmentioned factor in the HCBOR proposal is that the origin of the premium credits at issue was the steadily decreasing ACA enrollment, due to rising premium costs that weren’t supposed to happen with government direction of the health care insurance system. The premium credits did succeed in reversing that trend, as seen in the doubling of insurer Centene’s ACA enrollment from 3.3 million in 2023 to 5.9 million in 2025. Centene gave $38.88 million to Democratic Senate contenders between 2018 and 2024, as well as $19.16 million to Republicans.

Kendall’s proposal to enable “employees with coverage at work have the same level of federal financial assistance for premiums and out-of-pocket costs as those with ACA coverage” would extend ACA’s Cost-Sharing Reduction (CSR) program that lowers deductibles, copayments, coinsurance, and the annual out-of-pocket maximum for qualifying lower-income people choosing the ACA’s Silver Marketplace plan. Eligibility for CSR benefits are presently limited to households with income between 100% to 250% of the federal poverty level. The Third Way paper does not provide an eligibility formula, payment mechanism, or price tag for this initiative.

So, at the heart of the Third Way’s HCBOR is extending a taxpayer-funded premium subsidy that sends hundreds of millions of tax dollars to insurers and creates a new ACA subsidy for individuals who get their health insurance coverage via an employer, plus a price cap on drugs for such policyholders.

The remaining elements of the HCBOR include “hospital payment reforms like paying the same price for the same service and paying all large health systems a flat monthly fee instead of a fee for every service.” In a 2019 paper authored by Kendall, Hartney, and Jim Kessler, these new initiatives put forward in 2026 “would be paid for by protecting patients against high prices, realigning incentives to deliver better value for patients, reducing complexity for patients, and targeted tax increases on the wealthy.”

It should be noted that The Washington Stand reached out to Kendall to ask if he and co-author Hartney are proposing to bring back the ACA premium subsidies that expired last December. His response was this: “Working families are losing access to care as high deductibles, which Republicans have pushed, put treatment out of reach. The Affordable Care Act offers stronger protections than many employer plans. Third Way believes families with employer coverage deserve those same protections, along with caps on health care costs that Republicans allowed to expire.”

When TWS again asked specifically about the expired ACA premium subsidies, Kendall’s response did not speak to the question asked. Jon Cowan, Third Way’s president, did not respond to multiple TWS questions regarding the HCBOR.

Third Way’s 20-point proposal includes numerous proposals covering issues as diverse as how to cut the interest cost of buying used cars and creating universal child care to speeding up government permitting for proposed new energy infrastructure, making $7,500 “point-of-sale rebates” to enable lower- and middle-income buyers to purchase electric vehicles, and boosting the federal minimum wage to $15 an hour, plus much more. Watch this space in TWS for additional analyses in the coming days.