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Legal Immigration
+$6T
10-year policy advantage of legal immigration over mass deportation
The Choice Is Arithmetic, Not Politics
Attracting 20 million legal immigrants over 10 years — targeted at high-skill workers, university graduates, and critical tradespeople — generates a $6 trillion economic advantage over deporting the same number. This is not a partisan argument. It is math. The equivalent of the entire US defense budget for two years.
CBO · American Immigration Council · Social Security Trustees Report · MIT Living Wage Calculator · Pew Research Center
−137K
Net migration loss in 2025 — first time in 50 years
DHS · 2025
29K
Jobs/month by end of 2025 — down from 166K
BLS · 2025
2034
Social Security insolvency without a growing legal workforce
SS Trustees · 2024
$400B
Deportation enforcement cost — before any economic damage
AIC · 2024
Big Ideas
The Shipbuilding National Security Gap
In 2023, China delivered 972 commercial ships. The US delivered 7. China holds 57% of global market share — up from 14% in 2003. The US Navy needs 20–30 new vessels per year. Current production: ~5. This is a workforce problem — and it is solvable. A targeted skilled trades visa for shipbuilding creates high-wage jobs averaging $68,000/year in communities that have lost manufacturing employment for decades.
Stop Exporting What We Paid to Build
The US educates ~1 million international students annually. Most are required to leave after graduation. 58% of US computer science PhDs and 51% of engineering PhDs are held by temporary visa holders. The fast-track pathway converts brain drain into brain gain. STEM graduates average $82,000 starting salary and start businesses at twice the rate of native-born Americans.
The City Sponsorship Model
Detroit, Cleveland, St. Louis, and Dayton have lost 38–66% of their peak populations. Immigrants break the doom loop. Dayton's Welcome Dayton program turned immigrants — 5% of the population — into 9% of its business owners. Utica, NY is the only upstate New York city that is growing — driven almost entirely by immigrant entrepreneurs.
The Demographic Reality
South Korea's fertility rate hit 0.72 in 2023 — lowest ever recorded. China will lose 204 million people by 2054. The US has one advantage every other aging economy lacks: a legal immigration system capable of being reformed. Without it, America adopts Japan's economic trajectory. Slowly. Quietly. Expensively.
Social Security — The Math Is Simple
Social Security faces insolvency by 2034. 20 million new legal high-skill workers contribute $110 billion per year in FICA — vs. $13 billion currently from undocumented workers who cannot collect benefits. Result: solvency extended 7–8 years. Every senior's Social Security check is made more secure by a larger contributing workforce.
The Entrepreneurship Multiplier
Immigrants are 14% of the population but account for 25% of new business formation. If 15% of 20 million new legal immigrants start businesses employing an average of 6 Americans, that is 18 million new American jobs created as a downstream effect. 55% of American billion-dollar startups have at least one immigrant founder.
The 10-Year Comparison
Metric
Deport 20 Million
Attract 20M Legally
10-year execution cost
$400B+ enforcement, detention, legal
~$200B processing + integration
Cumulative GDP impact
−$7.9 trillion lost
+$23 trillion gained
10-year tax revenue
−$980B permanently lost
+$4.84 trillion new
Budget deficit
Adds $1.38T to deficit
Reduces by $4.64T
Social Security
Accelerates insolvency 4+ years
Extends solvency 7–8 years
American jobs
Eliminates 8M+ jobs
Creates 18M+ new jobs
Net 10-year swing
—
+$6 trillion vs. deportation
The 5 Legal Pathways — 20 Million by 2040
Pathway 1
University & STEM Fast-Track
International students graduating from US universities in STEM, healthcare, or engineering receive an expedited green card — bypassing the H-1B lottery. Requires English proficiency (verified by US degree), clean record, and employer or university sponsorship. Canada and the UK both offer post-graduation pathways. The US currently does not.
5M workers10-year target
$82,000avg annual wage
Pathway 2
Skilled Trades Sponsorship
A dedicated visa for shipbuilding, advanced manufacturing, pipefitting, welding, and electrical — roles with critical labor shortages. Employer-sponsored, workers commit to specific industries and regions. Addresses both the Navy's shipbuilding gap and the housing construction crisis. Modeled on Germany's Fachkraefteeinwanderungsgesetz.
4M workers10-year target
$68,000avg annual wage
Pathway 3
Healthcare Professional Recruitment
A targeted pathway for nurses, physicians, PAs, home health aides, and medical technicians — the roles most responsible for the rural hospital closure crisis. Priority: rural counties and underserved urban areas. Professional licensing serves as a natural language and competency screen.
3M workers10-year target
$78,000avg annual wage
Pathway 4
City & Town Sponsorship Program
Cities and counties formally sponsor immigrants for roles that have been unfilled for 12+ months. A 3-to-5-year residency commitment in exchange for expedited processing. Modeled on Canada's Provincial Nominee Program — which has waitlists, meaning qualified immigrants are eager to participate.
Flexibledrawn from all pathways
Prioritydeclining cities
Pathway 5
Employer Sponsorship Expansion
Expansion of existing employer sponsorship — streamlined processing, reduced wait times, increased annual caps for verified positions unfilled for 12+ months. Fills corporate talent gaps without requiring new program infrastructure. Requires professional-level English verified by employer.
3M workers10-year target
$75,000avg annual wage
Full Immigration Policy Brief — April 20269 sections · GDP modeling · Demographic analysis · City case studies · Full pathway framework · All sources cited
Download Full Brief →
Energy & Environment Policy Brief
In development · Publishing Q3 2026
$356B
Extracted by drug middlemen annually — before a single pill reaches a patient
The Big Idea: Medicare Part D for All Americans
Medicare already negotiates drug prices. The infrastructure exists. The legal authority exists. The precedent exists. The only question is who it covers. Right now the answer is seniors. The TheMajority.us position is simple: extend Medicare's negotiating power to every American. The same pill. The same manufacturer. The same negotiated price. No more $356 billion extracted by middlemen. No more paying 256% more than Germany for the identical drug. The majority already supports it. Current policy keeps reversing it.
Sources: USC Schaeffer Center 2025 · HHS ASPE Pharmaceutical Supply Chain Margins Report 2024 · RAND Corporation Drug Pricing Study · KFF Employer Health Benefits Survey 2025 · CMS National Health Expenditure Accounts 2024
$356B
Gross-to-net bubble — middlemen extracted from drug spending in 2024
USC Schaeffer · 2025
256%
Higher US brand-name drug prices vs. 32 comparable countries
RAND Corporation · 2024
74%
Of Americans support Medicare drug price negotiation — bipartisan majority
KFF · 2024
$100B
Annual savings if middlemen paid transparent fixed fees instead of list-price percentages
USC Schaeffer · 2025
The Big Idea
Supporting Evidence
The Five-Layer Middleman Chain — Nobody Touches the Patient
The full drug supply chain: Manufacturer → Wholesaler (3% markup) → GPO → PBM (31.2% margin) → Insurer → Pharmacy → Patient. HHS analysis found PBMs captured $60.6 billion in margin in 2022. Wholesalers took $23.4 billion. Pharmacies $12.2 billion. None of these entities manufactured, prescribed, or administered a single drug. By contrast, hospitals deliver surgery, diagnosis, and emergency care. Doctors deliver the clinical judgment that keeps people alive. The drug supply chain is structurally different — it is the one part of healthcare where most of the cost is extraction, not care.
Won, Then Weakened — The Legislative History of Medicare Negotiation
For two decades, the non-interference clause in the 2003 Medicare Modernization Act legally banned Medicare from negotiating drug prices — a provision written at pharma's request. The Inflation Reduction Act of 2022 ended that ban, projecting $237 billion in deficit reduction over 10 years. CMS negotiated prices for the first 10 drugs in 2024, with prices taking effect in 2026. Then the One Big Beautiful Bill (signed July 4, 2025) expanded orphan drug exemptions, removing drugs from negotiation eligibility and costing an estimated $5 billion in lost savings per the CBO. The majority has consistently supported negotiation. Policy keeps moving in the opposite direction.
The Doctor Shortage Makes Drugs the Right First Fix
The US faces a projected shortage of 37,800–124,000 physicians by 2034. 92% of rural counties are primary care shortage areas. 200 rural counties have zero primary care doctors. When people cannot get to a doctor, the prescription IS the healthcare system — the one touchpoint they have with treatment. Making drugs affordable is not a consolation prize for a broken system. It is the most direct intervention available to the 43 million rural Americans who live without enough primary care physicians and who depend on prescription access as their primary form of ongoing healthcare.
What the Small Business Worker Actually Pays
A worker earning $120,000 at a small business pays $9,017/year in family premium contributions — plus a $1,886 deductible before insurance covers anything. If their employer offers nothing, the ACA Marketplace costs $22,000–$28,000/year at that income level with minimal subsidies after the enhanced credits expired in 2025. That is nearly a quarter of gross income on healthcare before rent, food, or childcare. More than 1 in 8 American workers are in families spending over 10% of their income on healthcare. Medicare Part D for All caps the most negotiable piece of that burden immediately.
AI Makes Lower Prices and Innovation Compatible
The pharmaceutical industry's historic objection to price negotiation: lower prices kill R&D incentives. AI is dismantling that argument economically. Drug discovery costs are falling 30–70%. Development timelines are compressing from 10–15 years to 3–6 years. Phase I success rates are improving from 40–65% to 80–90%. Pharma AI investment grew from $4B to $25B between 2019 and 2025 — 600% growth — signaling the industry's own confidence in AI economics. When development costs fall this dramatically, companies can maintain healthy margins at lower prices. The first AI-designed drug approval is expected in 2026–2027. The renaissance is not theoretical. It is arriving.
Drugs Are 9% of Healthcare Spending — the Most Negotiable 9%
Prescription drugs account for $467 billion — 9% of total US healthcare spending. Hospitals are 31%. Physicians are 21%. But hospitals deliver surgery. Physicians deliver diagnosis. Drug middlemen deliver invoices. The 9% is the piece of healthcare spending where the US pays the most relative to peer nations, where the middleman extraction is most egregious, and where a single policy change — extending Medicare's negotiating authority — produces the largest immediate price reduction for the largest number of people. Reforming to transparent fixed-fee middleman payments alone could save $100 billion annually — more than the entire federal education budget.
Current System vs. Medicare Part D for All
Metric
Current System
Medicare Part D for All
Who Medicare negotiates for
Seniors only — 66M people
All 335M Americans
Drug price vs. peer nations
256% higher — no negotiation for most Americans
Maximum Fair Price — same leverage for everyone
Middleman extraction
$356B gross-to-net bubble annually
Fixed-fee transparency — estimated $100B in annual savings
Small business family (income $120K)
$9,017–$28,000/yr depending on employer offer
Drug costs capped at negotiated Maximum Fair Price
10-year deficit impact
OBBBA cost $5B in lost IRA negotiation savings
IRA negotiation projected $237B deficit reduction
PBM incentive structure
% of list price — incentive to keep prices high
Fixed admin fee — incentive is neutral on price
Majority support
74% support negotiation — policy runs against them
74% majority-aligned — bipartisan, consistent, validated by AI economics
The Healthcare Ladder — Part D for All Is Step 1
Step 1 — Now
Medicare Part D for All
Extend Medicare's existing drug price negotiation to every American. The Maximum Fair Price mechanism already exists — CMS negotiated the first 10 drug prices in 2024 and prices take effect in 2026. Step 1 expands that coverage universally, delinks PBM compensation from list prices, and requires 100% rebate pass-through to patients. No new system. No new infrastructure. The same negotiation, extended to 335 million people instead of 66 million. 74% bipartisan support. The majority is already there.
74%majority support
$237B10-yr deficit reduction
Step 2 — Near (2–3 Years)
Medicare Buy-In for Ages 18–30
Allow Americans aged 18–30 to buy into Medicare at cost. This is the generation most likely to skip coverage, most likely to start businesses, and most likely to delay care until crisis. Eliminating healthcare job-lock for young adults directly unlocks entrepreneurship — the connection to the Small Business Engine is direct. Countries with universal coverage have structurally higher startup rates because founders don't have to solve healthcare before solving their market. Physician supply expansion, medical school debt forgiveness tied to shortage area service, and immigrant physician fast lanes begin in parallel during this phase.
18–30target age group
Job-lockprimary barrier removed
Step 3 — Long (10–15 Years)
Medicare for All — Fully Funded Transition
A full transition funded through elimination of the $14,000 per-employee insurance burden that suppresses American wages and makes US businesses structurally uncompetitive against every peer nation whose government absorbs this cost. The economic argument: the US already spends $5.3 trillion — enough to cover everyone. The problem is not the money. It is the $356 billion extracted annually by entities that deliver no care. By Step 3, AI-reduced drug development costs, expanded physician supply, and the elimination of the PBM/GPO extraction layer make the transition fiscally viable. This is competitive economics — not social policy.
$14Kper-employee burden eliminated
10–15yrtransition timeline
Full Healthcare Policy Brief — Coming Q3 2026Complete PBM/GPO margin analysis · Medicare negotiation legislative history · Physician shortage data by county · AI drug discovery economics · 3-Step Ladder financial modeling · Small business cost comparison
Get Notified →
Education Policy Brief
In development · Publishing Q3 2026