Senator Rand Paul, one of Congress’ most ardent Libertarians, pitched a healthcare-cost solution that made him sound like a Democratic Socialist, and the internet noticed.
In a recent interview with Fox Business’ Maria Bartiromo, Paul said, “What if you could join Costco?” a major discount retailer with 44 million members. “If one person negotiated for all 44 and they bought a group plan like Toyota or General Motors does,” he added, referring to major car manufacturers able to negotiate lower health insurance costs for their employees due to their purchasing power.
Paul went on to say, a healthcare bargaining unit of that size, “would be the largest collective entity in the country. They would drive prices down by sheer might.”
A “Costco called America”
Rand Paul on his healthcare plan: "What if you could join Costco? Costco has 44 million members and if one person negotiated for all 44 and they bought a group plan like Toyota or General Motors does, they would be the largest collective entity in the country. They would drive… pic.twitter.com/ycDVrKfXqt
— Aaron Rupar (@atrupar) December 9, 2025
Not a bad idea, several comments pointed out, but it sounds a lot like Medicare For All, a proposal Paul has opposed. One comment noted, “What if there was a Costco called America with 340 million people in it, and they [paid] as a single entity.”
Another added, “Interesting, so if the entire country were on one plan, with 350 million members, the buying power would drive prices even lower! We could call it say, Medicare for All!” Or as another comment put it, “He’s describing Medicare for All run by Costco.”
Others pointed out that this is what the Affordable Care Act (ACA), also known as Obamacare, was supposed to do before Trump gutted it. The comment said, “So essentially you would have to mandate them to buy the insurance right to drive it down?” noting that the ACA individual mandate was supposed to produce that result before Trump reversed it.
“So why would you want to get me to buy insurance under Costco to drive down the cost if I am not mandated to?” the comment said. “Wouldn’t all 44m have to buy it in order for it to come down? So if that works, why not just mandate everyone in the US to buy into one big plan so the price comes down then?”
Paul’s Health Marketplace and Savings Accounts for All Act
Paul’s comment came as he introduced the Health Marketplace and Savings Accounts for All Act. The senator’s bill would let every American open an expanded Health Savings Account with higher contribution limits and broader allowable uses, including premiums.
It also allows membership-based groups, such as Costco, not just employers, to offer insurance plans and negotiate lower costs.
In a statement announcing the bill, Paul once again evoked Costco and Amazon Prime. It said in part, “With my plan, to provide the leverage needed to reduce the cost of premiums, nearly any conceivable membership entity, such as Costco or Amazon, would be empowered to collectively bargain on behalf of their members with health insurers to lower rates.”
To that end, one comment pointed out, “You need collective bargaining, I know [it’s] a bad word for MAGAs,” as collective bargaining is typically associated with socialism. But to Paul’s point, “one person is nothing against these big healthcare agencies,” the comment added.
