Create the UHP Trust Fund

Months 0–12 · Treasury (managing trustee), UHADiscuss this step

Every existing law, program, institution, or practice this step changes: what it is today, what happens to it, when, and what that costs or trades off.

What	Today	Change	Trade-off
Medicare Board of Trustees & trust-fund insolvency projections replacedYear 1 Federal programs	Annual reports project the HI trust fund's depletion date.	Become the UHP Trust Fund trustees with a contingency reserve and an automatic adjustment rule.	Clear early warnings; recurring 'insolvency' headlines continue to shape politics.
National Institutes of Health continues— Federal programs	The largest public funder of biomedical research.	Continues unchanged in the ledger. Optional increase to offset lower pharmaceutical R&D incentives (not costed). Non-commercial research $70.4B → $70.4B	Holding NIH flat isolates the coverage change; raising it would partly offset lost private R&D at a public cost.
CDC and state & local public health departments continues— Federal programs	Disease surveillance, vaccination programs, outbreak response.	Continue; a single national claims dataset gives near-real-time surveillance of diagnoses and prescriptions. Government public health $157.6B → $157.6B	Better surveillance data; health-data privacy concerns grow with public-health access.