By Christian Bonilla

Artificial intelligence is booming — and America’s power grid is struggling to keep up. 

At the World Economic Forum, President Trump recently warned that “We need double the energy we currently have in the United States for AI to be as big as we want to have it.” Elon Musk has echoed similar concerns, predicting that AI data centers could overwhelm the electricity supply next year. The Department of Energy predicts that AI-driven electricity demand could increase sixfold by 2030.

They’re right about the scale of AI’s electricity needs. But they’re wrong about the diagnosis. 

America doesn’t suffer from a lack of energy resources. We have vast oil and gas reserves, plus growing solar and wind energy capacity. The real problem is getting the electricity that’s already, or soon could be, generated from these energy sources to the data centers where it’s needed.

Solving this coordination challenge will require a new approach to energy infrastructure — one with an eye toward future needs.

This distinction between coordination and total capacity matters. If the problem were simply about generating more electricity overall, the solution would be straightforward: build more power plants and transmission lines to bring power to all the new data centers. But that would — and will — take years, if not decades. New transmission lines alone often take years to complete.

Instead, we need to build new data centers next to existing energy deposits — such as natural gas fields in places like West Texas, Oklahoma, North Dakota, and elsewhere — so that power-hungry data centers can build on-site generating plants and obtain the electricity they need, without having to connect to the broader grid. Using standardized data center designs and prefabricated components could further accelerate construction timelines and get data centers up and running years faster than previous generations of data centers built in traditional hubs like Northern Virginia or Silicon Valley.

Data center developers already recognize the advantages of this coordinated approach. A recent KPMG survey revealed that 77% of data center stakeholders consider it key to build alongside energy generation.

But in practice, data center developers often struggle to understand and vet energy producers. And in turn, those producers often misunderstand the needs of data center operators. 

This is a challenge even for the largest AI developers. The Stargate project, a $500 billion AI data center investment backed by OpenAI and SoftBank, chose Abilene, Texas, as its flagship site after fielding interest from sixteen different states — largely for Abilene’s energy availability, alongside other land and regulatory advantages. Despite the initial fanfare, practical challenges quickly tempered aspirations, and the initiative has mostly stalled. As a result, Stargate has quietly scaled back its 2025 ambitions to building a single data center — in Ohio.

To lead in the AI age, America will need more than chips and capital. It needs clearer rules, faster transactions between energy producers and AI developers, and a system that rewards coordination just as much as production.

If we solve this coordination challenge, America can lead the AI revolution and improve everything from health care to education to national security. But if we fail, we’ll be left with plenty of power — just not where it matters.

Christian Bonilla is the Co-Founder and Co-CEO of DMARK Energy Solutions. 

By David Eagle

Imagine ordering your favorite entree at the neighborhood restaurant you’ve gone to for years. It’s the same dish, off the same menu, delivered by the same server. But suddenly, it costs 800% more – because the place just got new owners.

Few diners would accept such naked price-gouging.

Unfortunately, what’s unthinkable in the restaurant industry is standard fare in health care. Federal law and regulations allow hospitals to charge Medicare much more than independent physicians charge Medicare for the exact same procedures and health care services.

This structural inequity costs taxpayers and patients billions of dollars each year – and it will only get worse if Congress doesn’t act.

Hospitals have spent much of the last decade buying up independent physician practices. Between 2019 and 2024, they acquired some 7,600 physician practices nationwide, allowing them to reclassify those practices as hospital outpatient departments, according to the Physicians Advocacy Institute.

For hospitals, acquiring physician practices is a smart financial move. On the flip side, such hospital-driven consolidation is a raw deal for patients and taxpayers.

Routine services such as echocardiograms and colonoscopies are much more expensive when performed in a hospital rather than in a physician’s office or an ambulatory surgery center.

A peer-reviewed study that I co-authored this year in the Journal of Market Access and Health Policy proves as much – and shows just how costly those hospital referrals can be. We found that Medicare beneficiaries treated by hospital-affiliated physicians had just a 37% chance of receiving care in the lowest-cost setting.

The cost implications are massive. Consider a cystoscopy, a procedure used to diagnose and treat problems in a person’s urinary tract. In a hospital setting, Medicare pays $731 for the procedure. In a doctor’s office, Medicare pays just $239.

For some procedures, total Medicare reimbursement was eight times higher in a hospital outpatient department than in an ambulatory surgery center or doctor’s office.

This disparity imposes a hefty burden on federal taxpayers who bear the burden of paying for Medicare, and it also drives up premiums and cost-sharing for Medicare beneficiaries themselves.

The high payments give hospitals more revenue, which they are using to buy up additional physician practices and consolidate their markets even more, exacerbating the problem.

Congress and regulators have previously taken small steps to make Medicare payments more equal across different sites of care and to eliminate some of the perverse incentives that encourage hospitals to acquire independent physician practices.

For example, the Bipartisan Budget Act of 2015 directed the Centers for Medicare and Medicaid Services to stop using the higher hospital payment system for services furnished in physician practices that were acquired by hospitals and became part of the hospitals’ off-campus provider departments after the law’s effective date. Unfortunately, the rule doesn’t apply to any other services, such as diagnostic tests and procedures.

What Congress should do now is to embrace reforms that would require Medicare to pay the same price not just for clinic visits but also for services – regardless of where they’re performed.

Enacting payment reform would yield significant savings for Medicare – to the tune of more than $200 billion over 10 years, according to a 2023 study.

If Congress demands that Medicare standardize reimbursements for health care services and procedures – regardless of where or from whom patients receive them – private health insurance companies would follow suit.

Restaurant-goers wouldn’t accept it if a neighborhood cafe started charging higher prices for the same dishes under new ownership. Likewise, when hospitals buy up medical practices, patients and taxpayers shouldn’t have to pay more for the same diagnostic tests, procedures and other healthcare services either.

David Eagle, M.D., is a board-certified hematologist-oncologist and president of the American Independent Medical Practice Association. This piece originally ran in U.S. News & World Report.

By John Stanford

This month, the Centers for Medicare & Medicaid Services will begin meeting with patients who use the 15 drugs it selected for the second round of Medicare price “negotiations” — including weight-loss treatment Wegovy. 

CMS will use these discussions to inform the lower prices it’ll set for the medicines. What CMS won’t address is the growing list of drugs that’ll never be developed as a result of government price-setting. 

It’s been less than three years since the Inflation Reduction Act authorized the price negotiation program. Already, several companies have cited the law as a reason for pulling the plug on research programs and treatments for cancer, psychiatric disorders, and other serious conditions. Nearly 50 research programs and 24 drugs have been discontinued since the law was enacted.

Thankfully, President Trump just signed an executive order calling on Congress to roll back the Inflation Reduction Act’s most damaging provisions. Without reform, the number of discontinued treatments will grow — and so will the number of people whose lives could have been saved by those foregone medicines.

One provision stands out: the law’s “pill penalty.” 

The IRA doesn’t treat all medicines equally. “Small molecule” medicines, typically pills or tablets, face price-setting just 9 years after FDA approval. 

By contrast, biologic drugs, which are typically administered via injection or infusion at hospitals or doctor’s offices, don’t face price-setting until they’ve been on the market for 13 years.

As a result of this disparity, companies and investors are turning away from small molecule research. 

The CEO of Novartis warned that companies are deprioritizing small molecule therapies for the elderly. Pfizer announced that it’ll steer its oncology portfolio away from small molecules due to the IRA.

Investments in small molecule treatments have dropped 70%. Bristol Myers Squibb — the maker of blood thinner Eliquis, one of the first drugs selected for Medicare price negotiations — plans to trim spending by $3.5 billion over the next two years. The effort will lay off at least 2,000 employees and has already led to cuts at cancer research facilities.

These losses track with what my organization is hearing. 87% of life science investors now have less interest in funding small molecule research and development.

That’s a looming disaster for patients and taxpayers. Small molecule drugs account for the majority of all medicines. They’re easier for patients to take and more cost-effective than biologics. 

Yet because of the IRA, fewer small molecule drugs will secure the financing they need to make it out of the lab and into local pharmacies.

Lawmakers can restore the balance. The Ensuring Pathways to Innovative Cures Act would give small molecule drugs the same 13-year reprieve from price-setting that biologics receive — encouraging companies to make research investments based on scientific promise, rather than molecular weight.

The lawmakers who created the Medicare drug price negotiation program had good intentions. But in their quest for lower drug prices, they’re ensuring that many experimental treatments are never developed.

Unless policymakers reverse course, the cost will be measured in human lives.

John Stanford is the executive director of Incubate, a Washington-based coalition of life sciences venture capitalists. This column originally appeared at DCJournal.com.

By Eric Ruark

Ask most Republicans or right-leaning voters for their thoughts on “environmentalism,” and you’ll hear a litany of complaints about progressives’ attempts to remake our economy, increase the cost of living, and regulate small businesses into the ground.

It’s simply a political reality that campaigns against eating meat and zoning battles to outlaw single-family homes — not to mention the war on oil and natural gas — have made “environmentalist” practically a dirty word on the Right.

And that’s a problem, because protecting our environment, conserving our natural resources for future generations, and promoting a high quality of life for all Americans are fundamentally conservative endeavors.

This isn’t an attack on or a defense of the political Right. It’s an argument that it’s long past time for the Right to seriously take up the mantle of environmental stewardship rather than ceding it to the radical Left. And that project must begin with addressing the urban sprawl that’s been devouring our fields, forests, coasts, and rivers for decades — largely thanks to population growth driven by immigration.

The United States gained almost 90 million people over the last forty years. We’re on track to add another 65 million or so by 2060.

All that growth has consequences. Between 2002 and 2017, urban sprawl consumed more than 17,000 square miles of previously open spaces — an area roughly twice the size of New Jersey. And a whopping two-thirds (67%) of that land loss resulted from constructing new houses, shopping venues, roads, and other infrastructure to accommodate increased demand from a growing population.

All this sprawl fundamentally disrupts the places and ways of life we hold dear. A study from the U.S. Department of the Interior and North Carolina State University predicts that, based on current trends, the Southeast will eventually become one “megalopolis,” a “seamless” urban corridor stretching from Raleigh, NC to Atlanta, GA, “at the expense of agricultural and forest lands.”

There’s nothing conservative about that.

Fortunately, this future isn’t inevitable. Voters have the power to chart a different course.

Local ordinances are a good place to start. Consider how zoning regulations can protect certain areas from new development. Libertarians may gripe about government overreach, but reasonable people recognize zoning for what it is: a legitimate way for local citizens to prevent unwanted growth and unwelcome change.

The federal government, though, plays the biggest role. It grants lifetime residency and work permits to over one million legal immigrants each year — a number that has stayed relatively consistent for decades, regardless of which party holds the White House.

Republicans in Congress have proposed reforms to decrease both legal and illegal immigration — which would curtail the population growth that’s transforming communities nationwide.

In 2023, the House passed a sweeping immigration bill that would end catch-and-release, end abuse of parole that was rampant under the Biden-Harris administration, and require every U.S. employer to check the legal status of recent hires through E-Verify. Republicans have also sponsored bills that would reduce “chain migration,” which enables recent immigrants to sponsor their overseas relatives for green cards — regardless of whether those relatives have the skills to succeed in the 21st century economy.

If tens of millions more people move to the United States in the coming years, the dreaded army of bulldozers, cement-rollers, and tree-cutters will only keep advancing. There’s no way around it.

For too long, the environmental movement has been dangerously politicized. While the Left has done little actual conservation, many on the Right have defaulted to opposing conservation efforts on “principle.” This has to change. Maybe the debate over how to manage future immigration flows will be the catalyst.  

Eric Ruark is Director of Research for NumbersUSA. This piece originally appeared in the Palm Beach Post.

By Eric Ruark

CNBNews Exclusive

Ask most Republicans or right-leaning voters for their thoughts on “environmentalism,” and you’ll hear a litany of complaints about progressives’ attempts to remake our economy, increase the cost of living, and regulate small businesses into the ground.

It’s simply a political reality that campaigns against eating meat and zoning battles to outlaw single-family homes — not to mention the war on oil and natural gas — have made “environmentalist” practically a dirty word on the Right.

And that’s a problem, because protecting our environment, conserving our natural resources for future generations, and promoting a high quality of life for all Americans are fundamentally conservative endeavors.

This isn’t an attack on or a defense of the political Right. It’s an argument that it’s long past time for the Right to seriously take up the mantle of environmental stewardship rather than ceding it to the radical Left. And that project must begin with addressing the urban sprawl that’s been devouring our fields, forests, coasts, and rivers for decades — largely thanks to population growth driven by immigration.

The United States gained almost 90 million people over the last forty years. We’re on track to add another 65 million or so by 2060.

All that growth has consequences. Between 2002 and 2017, urban sprawl consumed more than 17,000 square miles of previously open spaces — an area roughly twice the size of New Jersey. And a whopping two-thirds (67%) of that land loss resulted from constructing new houses, shopping venues, roads, and other infrastructure to accommodate increased demand from a growing population.

All this sprawl fundamentally disrupts the places and ways of life we hold dear. A study from the U.S. Department of the Interior and North Carolina State University predicts that, based on current trends, the Southeast will eventually become one “megalopolis,” a “seamless” urban corridor stretching from Raleigh, NC to Atlanta, GA, “at the expense of agricultural and forest lands.”

There’s nothing conservative about that.

Fortunately, this future isn’t inevitable. Voters have the power to chart a different course.

Local ordinances are a good place to start. Consider how zoning regulations can protect certain areas from new development. Libertarians may gripe about government overreach, but reasonable people recognize zoning for what it is: a legitimate way for local citizens to prevent unwanted growth and unwelcome change.

The federal government, though, plays the biggest role. It grants lifetime residency and work permits to over one million legal immigrants each year — a number that has stayed relatively consistent for decades, regardless of which party holds the White House.

Republicans in Congress have proposed reforms to decrease both legal and illegal immigration — which would curtail the population growth that’s transforming communities nationwide.

In 2023, the House passed a sweeping immigration bill that would end catch-and-release, end abuse of parole that was rampant under the Biden-Harris administration, and require every U.S. employer to check the legal status of recent hires through E-Verify. Republicans have also sponsored bills that would reduce “chain migration,” which enables recent immigrants to sponsor their overseas relatives for green cards — regardless of whether those relatives have the skills to succeed in the 21st century economy.

If tens of millions more people move to the United States in the coming years, the dreaded army of bulldozers, cement-rollers, and tree-cutters will only keep advancing. There’s no way around it.

For too long, the environmental movement has been dangerously politicized. While the Left has done little actual conservation, many on the Right have defaulted to opposing conservation efforts on “principle.” This has to change. Maybe the debate over how to manage future immigration flows will be the catalyst.  

Eric Ruark is Director of Research for NumbersUSA. This piece originally appeared in the Palm Beach Post.

By Sally C. Pipes

The Department of Government Efficiency’s crackdown on waste, fraud, and abuse is off to a fast start. But as an engine of government savings, DOGE still has substantial untapped potential.

That’s because it hasn’t yet addressed the fraud crippling one of the federal government’s largest programs: Medicare. In fiscal year 2023 alone, “improper payments” in Medicare eclipsed $50 billion.

GUEST OPINION

If DOGE wants to put a real dent in government overspending while changing millions of Americans’ lives for the better, it won’t find a better target than Medicare fraud.

The legacy of Medicare after 60 years is one of relentless growth — both in the number of beneficiaries and in spending. Medicare expenditures now exceed $1 trillion annually.

But the program’s growth has only weakened its ability to effectively oversee its finances — creating a fat target for scam artists who calculate their odds of success are high and their risk of getting caught is low.

The numbers paint an alarming picture. In fiscal year 2024, 7.66% of the payments Medicare’s Fee-for-Service program made to providers were “improper,” meaning they failed to comply with legal requirements. Those payments totaled more than $31 billion.

The improper payment rates for Medicare Advantage and the Medicare prescription drug benefit were not much better — 5.61% and 3.70%, respectively. That translates into a total of over $22 billion in improper payments across the two programs in fiscal 2024.

In all, Medicare accounts for nearly one-fourth of the funds improperly spent by the government each year, according to a report from the Government Accountability Office.

That’s a pitiful record — and has real human consequences, both for seniors and for taxpayers.

Consider some of the most egregious cases of Medicare fraud. Earlier this year, a couple from Arizona “pleaded guilty for causing over $1.2 billion of false and fraudulent claims to be submitted to Medicare and other health insurance programs for expensive, medically unnecessary wound grafts that were applied to elderly and terminally ill patients,” according to the U.S. Department of Justice.

In 2023, the Department of Justice charged 23 Michigan residents with nabbing more than $61.5 million from Medicare for unnecessary home health services. The feds allege that the defendants set up a complex web of home healthcare agencies in Detroit using straw owners — such as family members — and then paid bribes and kickbacks to recruiters to gain additional patients.

Every dollar spent improperly — or fraudulently — in Medicare is a dollar that can’t go to a senior with legitimate healthcare needs.

Policymakers have already identified numerous concrete strategies for reforming the program. One is to ensure that Medicare pays the same amount for equivalent services no matter where they’re provided. This change, which has long been championed by GAO, could save taxpayers more than $140 billion over the next decade.

Another potential reform would be to conduct more thorough audits of payments and claims. Auditors working at the state level have historically been successful at identifying fraud. Using their insights to improve federal Medicare oversight could help policymakers keep managing the program effectively as it continues to grow.

Work of the sort DOGE is doing is sorely needed. Waste and fraud run rampant in the federal government. Reforming Medicare can save not just money but lives.

Sally C. Pipes is President, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is The World’s Medicine Chest: How America Achieved Pharmaceutical Supremacy — and How to Keep It (Encounter 2025). Follow her on X @sallypipes. This piece originally ran in the Detroit News.