People's Solidarity Fund
Community · Governance · Direct Care
PSF is in development and is not yet accepting members or contributions.
The People's Solidarity Fund is a member-owned, democratically governed cooperative for whole-person care: primary care anchored in Direct Primary Care, behavioral health, and integrative wellness. Incubated by Build Better Health, it is the build-the-replacement side of our work. Members pay income-based contributions into Solidarity Health Accounts held in their own names and pay participating providers directly at transparent, publicly posted rates, with no insurance middle layer, no prior authorizations, no claim denials, and no clawbacks. Surplus is reinvested into care rather than extracted as profit. There is no pooled fund: support among members is voluntary and member-initiated. PSF is not insurance and complements coverage rather than replacing it, connecting members to advocates and partners for catastrophic needs. The pilot, PSF Kentucky, launches in Louisville in 2027.
PSF is a health care financing model in development. Its structure, legal status, and regulatory classification are under active review by counsel. This page will be updated once counsel has approved final descriptive language.
The Proposed Model
Income-Based Contributions
A proposed sliding-scale contribution structure designed to make participation accessible across income levels. Subject to legal and regulatory review.
Personal Health Accounts
Proposed individual accounts where contributions are held and used to pay providers directly, keeping funds transparent and participant-controlled.
Direct Provider Payment
A proposed model for paying providers directly, without insurer intermediaries, reducing administrative burden and improving care access.
Community Support Pool
A proposed collective pool to assist participants when individual accounts fall short, governed by democratic member oversight.
Member-Governed Structure
Participants and providers co-govern through a democratic structure, without shareholder control or profit extraction.
All structures are proposed and subject to legal review and regulatory requirements. PSF is not operational and is not currently accepting contributions.
Our Values
Provider-Led
Clinicians with lived experience of broken systems leading strategy, governance, and action.
Collective Care
Collective support over market-based competition, centering community over profit.
Radically Transparent
Open books, public dashboards, strict administrative caps, and no hidden profit extraction.
Community Governance
Members and providers co-govern democratically, without shareholder control or profit motives.
Bold and Unapologetic
We name systemic failures explicitly and demand structural accountability without compromise.
Sustainability Over Burnout
Fair compensation, reasonable workloads, and long-term movement resilience for all participants.
How It Works
Members contribute based on their income. Those contributions sit in their own personal health account and are used to pay providers directly, without an insurer in the middle.
A separate community support pool helps participants when their individual account falls short, governed by the members themselves.
All structures are proposed and subject to legal review. PSF is not yet operational.
Where We Are
Design
Building the model, governance structure, and regulatory framework.
Legal Review
Counsel finalizes regulatory classification and member agreements.
Louisville Pilot
First community pilot launching in Louisville, KY with local providers and members.
Replication
Expanding the model to additional states and communities.
An initiative of Build Better Health, a federally recognized 501(c)(3), guided by an advisory board including parity litigation counsel and a former health-plan chief medical officer.
Louisville community: Interested in Pilot?
Are you a Louisville-area resident or provider? We are building the PSF pilot community now. Express interest to be among the first invited when the pilot opens in 2027.
Providers: Interested in People’s Solidarity Fund?
Clinicians interested in participating in the PSF provider network or joining the Provider Council can express interest now. We are building the provider side of the model alongside the member side.