Medicare and Medicaid will devour more than a third of federal government spending within a decade. Republicans take a beating every time they try to slow that growth, with Democrats remaining eager to paint the GOP as the party of throwing granny off a cliff.
But there is a way out of this broken cycle. Innovation and efficiency can break through the false choice of benefit cuts on the one hand or tax hikes on the other. President Donald Trump is already quietly executing this strategy, leveraging artificial intelligence and American energy to deliver meaningful healthcare wins.
Start with the math. The Congressional Budget Office estimates federal health spending climbing well past 6% of GDP and accelerating through the 2030s and 2040s. The traditional toolkit — trimming benefits, means-testing, payroll tax hikes — has gone nowhere for decades. With the midterm elections currently predicted to deliver punishing losses for Republicans, reining in runaway federal spending is not on the legislative table.
HOW CONGRESS CAN DELIVER HEALTHCARE AFFORDABILITY AND MITIGATE INFLATION REDUCTION ACT DISASTER
But what if we tried attacking the cost of delivering care?
This is where AI enters the picture, not to replace healthcare professionals but to make up for staffing shortages.
The Association of American Medical Colleges projects a deficit of up to 86,000 physicians by 2036. Nursing shortfalls are already straining emergency departments nationwide. The system is trying to meet the demands of an aging population with insufficient new medical professionals entering the workforce. AI won’t replace doctors, but it can take care of the things doctors waste time on — documentation, prior authorizations, triage screening, medication reconciliation. Every task delegated to AI is a few minutes of physician time returned to actual patients. Multiply that by millions of tasks and you can see the savings add up.
The Trump administration understands this. The Department of Health and Human Services has been advancing AI integration across clinical practices and reimbursement structures. They are rightly directing healthcare providers to use AI tools where they reduce the administrative friction that accounts for a massive share of American healthcare’s cost premium over peer nations.
The catch, of course, is that AI is not free to run. Data centers already consume an estimated 2%-3% of U.S. electricity and could hit nine to 10% within a decade as AI workloads climb. If you want AI-powered healthcare at national scale — smart diagnostics in rural clinics, AI-assisted radiology in community hospitals, automated billing across a 330-million-person insurance system — you need energy, and you need it cheap.
This is why Trump’s energy agenda is not a separate issue from healthcare, or even our fiscal health. They are all related. And the Trump administration is integrating them all to maximum effect.
The administration’s Ratepayer Protection Pledge, introduced at this year’s State of the Union, requires AI companies to bear the full infrastructure cost of their energy consumption rather than offloading it onto household electricity bills. Seven major tech firms have already signed. That will help keep AI adoption from becoming a hidden tax on the patients and hospitals that depend on the grid — and could even cap energy price hikes.
Meanwhile, nuclear executive orders, expanded natural gas production, and nearly $290 billion in available Energy Department lending are aimed at scaling supply to meet demand. The goal is, as it ought to be, energy abundance, independence, and dominance. There is no need to choose between solar and natural gas, or between nuclear and wind. The important thing is to get every source of American energy infrastructure up and running at scale, powering data centers, hospitals, and the manufacturing facilities that make America the world leader in medical technology.
As attacks on Iran’s energy infrastructure and the closure of the Strait of Hormuz push crude and natural gas prices higher, the need for advanced American energy only increases. American energy dominance is, therefore, not only the key to our national security, but to AI innovation and healthcare cost savings.
Trump ran on energy dominance. He also ran on lowering drug prices and delivered, with TrumpRx offering discounted rates on 40 medications and swift executive action pushing pharmaceutical companies to compete on price. These issues may look unrelated, but they represent a single coherent strategy: cheap energy enables AI adoption, AI adoption drives down the cost of care, and lower costs are how you protect Medicare and Medicaid without gutting them or raising taxes.
CORPORATE HOSPITALS ARE DRIVING UP HEALTHCARE COSTS FOR THE REST OF US
That’s the message Republicans should be making loudly heading into the midterm elections. The benefit-cut vs. tax-hike frame is a losing argument no matter which side you take. Instead of choosing a losing side, Trump offers a third way — an energy agenda that makes AI affordable enough at scale to transform healthcare.
Trump has given Republicans a winning argument they need to cut health care costs and save Medicare and Medicaid. They should use it.
Chet Love is CEO of Cornerstone Group and also serves on the board of the Family Health Sciences Institute.