1. United States
2. Letter

Your “direct pay” plan is not bold. It is cruel. You are taking a system that spreads risk and protects people—the Affordable Care Act—and trying to replace it with one that tells sick people to fend for themselves. That is not reform. That is abandonment. People do not choose when they get cancer. They do not plan for heart attacks or broken bones. Most families do not have the cash to “pay direct” for care that can cost tens or hundreds of thousands of dollars. You know this. Everyone knows this. The ACA, for all its flaws, made sure people could not be denied for preexisting conditions. It helped low-income families get care. It kept hospitals open in poor and rural areas. Your plan strips that away. Who suffers? Not the wealthy. Not you. It is the working poor. The sick. The disabled. The people already hanging by a thread. They will delay care, get sicker, and die sooner—because they cannot pay. That is the outcome of your policy. A government that shifts risk onto its weakest people is not strong. It is failing. And right now, that failure is yours. Fix the system if you want. But do not destroy the only safeguards millions have.