With healthcare costs continuing to weigh on American families, Rep. Jim Clyburn says the path forward should begin with three “A’s”: accessibility, affordability, and accountability.
Clyburn joined Meidas Health’s Dr. Vin Gupta for a wide-ranging conversation about the future of healthcare in America, from strengthening the Affordable Care Act and protecting rural hospitals to lowering prescription drug costs, regulating artificial intelligence, and safeguarding medical research.
Meidas Health, a series hosted by renowned physician, public health expert, and MSNBC contributor Dr. Vin Gupta , shines a spotlight on the public health threats posed by Donald Trump and his extremist allies by chatting with experts and policymakers, combating the Trump regime’s health lies with the truth.
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Clyburn explained to Gupta that these challenges are deeply connected.
“It’s one thing for something to be affordable,” Clyburn told Gupta. “It’s something else for it to be accessible.”
He pointed to his home state of South Carolina, where he said high rates of amputations related to late detection of diabetes helped shape his thinking about healthcare access years ago. Clyburn recalled working to bring mobile health units into rural communities so patients could receive testing and identify illnesses earlier.
That experience helped form what he now calls his “three A’s”: accessibility, affordability, and accountability. If Democrats regain congressional power, Clyburn said those principles should guide their approach to healthcare policy, with a particular focus on expanding the reach of federally qualified community health centers.
Gupta asked Clyburn, who played a major role in the passage of the Affordable Care Act, what he views as the unfinished business of American healthcare reform.
Clyburn argued that policymakers should identify weaknesses in the ACA and address them directly while reversing policies he believes have made accessing coverage more difficult.
The conversation then turned to one of the most acute healthcare challenges facing communities across the country: the survival of hospitals, particularly in rural America.
Clyburn said rural hospital closures have been a persistent problem and called for Medicaid expansion in states that have yet to adopt it. He also argued that access to healthcare should not depend on where someone happens to live.
“We should not have things like just care determined by what zip code you may live in,” Clyburn said.
He again pointed to federally qualified community health centers as an existing model that can provide primary care and other essential services in communities where traditional healthcare infrastructure is limited.
Gupta, a practicing physician, also pressed Clyburn on one of the biggest questions confronting medicine, which is artificial intelligence.
AI has the potential to help patients navigate a healthcare system plagued by shortages and uneven access, Gupta noted, but patients also want to know that a human remains involved in consequential medical decisions.
Clyburn compared the emergence of AI to earlier technological revolutions: capable of producing enormous benefits while also carrying serious risks.
“What we’ve got to do, in my opinion, is put in place guardrails,” he said.
Clyburn argued that the same technological expertise being used to build increasingly powerful AI systems should also be directed toward developing safeguards that protect patients, the broader public, and national security.
For healthcare, that debate could become particularly consequential. AI may eventually help expand access in underserved communities, but Gupta emphasized that medicine cannot simply remove clinicians from the equation. Patients need to be able to trust how these systems are being used and understand who remains accountable for their care.
The conversation also turned to prescription drug costs and whether Washington should make more aggressive use of government purchasing power to lower prices.
Gupta pointed to state-level experiments, including California’s efforts to reduce the price of essential medications, and asked whether successful state programs could eventually provide a blueprint for federal action.
Clyburn said states have historically served as incubators for policies that can later be expanded nationally.
He cited federally qualified community health centers as one example of an idea that developed locally before becoming part of the national healthcare infrastructure.
“It may be that the birthplace of this is California,” Clyburn said of new approaches to drug affordability. He argued that Washington should be willing to study successful state experiments and determine whether they can be transformed into national programs.
Gupta closed the conversation by asking Clyburn to look beyond the immediate political battles and imagine American healthcare a decade from now.
What lasting reform would he most like to see?
For Clyburn, the answer begins with research.
He spoke personally about his late wife’s decades-long battle with diabetes and pointed to diabetes, cancer, and other diseases as areas where the United States should continue aggressively pursuing breakthroughs.
Clyburn also warned against allowing preventable diseases to regain ground and said medical research needs sustained support.
“I would love to see research properly funded, safeguarded and protected from the kind of misinformation that seems to be plaguing it today,” he said.
Gupta agreed, arguing that the integrity of institutions such as the National Institutes of Health is essential to answering difficult questions about disease, disparities, and public health.
Watch the full episode of Meidas Health above.
