Dear Fellow Citizen,

We’re writing to you about a rare opportunity—one that happens quietly, without fanfare, but with real consequences for how healthcare will work in the age of artificial intelligence.

Right now, the Department of Health and Human Services is asking a question: How should AI be used in American healthcare? They’ve opened a 60-day public comment period. The deadline is February 23, 2026. Your response becomes part of the legal record that shapes policy.

This isn’t a petition. It’s not a poll. Under the Administrative Procedure Act, federal agencies must consider what you say. If you participate, you don’t just express an opinion—you exercise democratic power.

Most people will never hear about this opportunity. That’s exactly why we’re reaching out.

The Question We’re Really Answering

HHS asks how to “accelerate AI adoption,” “reduce regulatory uncertainty,” and “deflate healthcare costs.” Those are important questions. But they’re not the most important question.

At Moonshot Press and through Project 2026, we believe the central question is this:

How do we build a healthcare system where everyone can get the care they need to live healthy, flourishing lives?

That question changes everything. Because if the goal is human flourishing, then AI becomes a tool to support that goal—not an end in itself.

It means asking whether AI will help prevent disease, or just process it more efficiently. Whether it will expand access to care, or concentrate it further. Whether it will make healthcare more comprehensible to families navigating confusing systems, or add another layer of opacity.

It means starting with what creates and maintains health—what researchers call the “salutogenic” approach—rather than just what treats disease after it appears.

And it means recognizing that the people best positioned to answer these questions are not algorithms, administrators, or even experts. It’s you. It’s all of us. It’s citizens.

Why AI Matters for Your Health

Artificial intelligence is already reshaping healthcare in ways most people don’t see:

• Algorithms help decide which patients get flagged as high-risk

• AI systems review insurance claims and recommend approvals or denials

• Predictive models identify which communities need preventive resources

• Machine learning tools analyze medical images and suggest diagnoses

Some of these applications are genuinely helpful. Others create new problems—bias in risk scoring, unexplained denials, decisions no one can challenge because “the algorithm said so.”

But here’s what matters: AI could be so much more than a back-office efficiency tool.

Imagine AI systems that help new parents understand their baby’s development and connect them to support before problems become crises. Tools that translate complex medical information into plain language so people can make informed decisions about their own care. Systems that identify social and environmental factors making people sick and help communities address them before disease takes hold.

Imagine AI designed not to optimize hospital billing, but to help families stay healthy in the first place.

That’s possible. But only if citizens demand it.

What Moonshot Press Is Doing

We’re submitting a comprehensive response to the HHS Request for Information. Our submission will argue for four core priorities:

1. Prioritize the First Thousand Days
The period from pregnancy through age two shapes lifelong health. AI tools supporting families during this critical window could prevent chronic disease for decades. Yet the RFI doesn’t mention early childhood once. We’re making the case that this should be a top research and funding priority.

2. Build AI for Patients, Not Just Providers
Most AI discussion focuses on administrative efficiency. We’re arguing that patient-facing tools—systems that help people understand diagnoses, navigate insurance, access preventive care—may do more to improve health outcomes than backend optimization ever could.

3. Design for Transparency and Trust
People need to know when AI is making decisions about their care, understand how those decisions are made, and have real ways to challenge them. We’re proposing that federal funding and reimbursement be conditioned on AI systems meeting transparency standards.

4. Reframe Cost Reduction as Prevention
True cost deflation doesn’t come from faster billing. It comes from keeping people healthy in the first place. We’re making the economic case that prevention-focused AI will reduce spending far more than efficiency-focused AI ever could.

But here’s the thing: our response isn’t the point. Citizen participation is the point.

What Project 2026 Is Building

Project 2026 is our initiative to rebuild democratic capability—to ensure that “government of the people, by the people, for the people” works in practice, not just in principle.

It’s built on three pillars: Democracy, Opportunity, and Citizenship.

Democracy means citizens have real power to shape decisions that affect their lives—not through protests or petitions, but through formal mechanisms like the Administrative Procedure Act.

Opportunity means everyone has access to the conditions needed for a flourishing life—including health, which is foundational to everything else.

Citizenship means showing up, learning together, and taking responsibility for governing the systems we all depend on.

The HHS RFI is a perfect test case. It’s technical enough that most people feel excluded. It’s consequential enough that exclusion matters. And it’s open enough that informed participation can genuinely influence outcomes.

So we’re not just submitting our response. We’re building infrastructure to help others participate:

• Plain-language guides explaining what the RFI really asks

• Evidence-based frameworks for thinking through complex tradeoffs

• Practical templates showing how to write effective comments

• Collaborative spaces where citizens can discuss, draft, and refine arguments together

• A complete series of articles providing the context, history, and substance you need to engage meaningfully

We’re treating this as a demonstration: Can citizens meaningfully participate in complex technical policy? Can democracy adapt to technological acceleration? Can governance be both expert-informed and democratically accountable?

We believe the answer is yes. But only if we do the work.

Why Your Voice Matters

You might be thinking: “I’m not an expert in AI or healthcare policy. What do I have to contribute?”

Everything.

Experts can tell you how algorithms work. Only you can tell them what problems need solving.

If you’ve raised children, you know what support would have mattered most in those early years—and what was missing. If you’ve navigated chronic illness, you understand which parts of the healthcare system are unnecessarily complex and which AI tools would actually help. If you’ve dealt with insurance denials or confusing medical bills, you know exactly where transparency matters.

Your lived experience is evidence. Policy should reflect it.

Effective comments don’t require technical expertise. They require specificity. Instead of saying “AI should be fair,” describe what fairness looks like in your life. Instead of saying “costs matter,” explain which costs fall on you and your family. Instead of saying “transparency is important,” identify which decisions you’d want to understand and challenge.

That’s all democracy requires. And it’s everything it needs.

A Moment That Matters

We’re living through a rare convergence. Artificial intelligence is reshaping healthcare faster than democratic institutions can process. The Department of Health and Human Services is explicitly asking for public input. The Administrative Procedure Act gives that input legal weight. And we’re approaching the 250th anniversary of the Declaration of Independence—a moment to ask whether we’re living up to the promise that governments derive their just powers from the consent of the governed.

This isn’t about opposing AI or resisting change. It’s about ensuring that change serves human flourishing rather than just system efficiency.

It’s about insisting that a healthcare system spending nearly twice as much per capita as peer nations while achieving worse outcomes needs to optimize for different goals.

It’s about recognizing that the most powerful technology in human history should be guided by the most fundamental democratic principle: that sovereignty belongs to the people.

The comment period closes February 23, 2026. Between now and then, we’re doing everything we can to make participation meaningful, accessible, and effective.

We hope you’ll join us.

How to Get Involved

Follow our series: We’re publishing weekly articles through February at moonshot.press/rfi-response, covering everything from the Administrative Procedure Act to the salutogenic framework to our complete submission.

Use our tools: We’re creating templates, guides, and frameworks to help you craft your own comments.

Join the discussion: We’re hosting online forums where citizens can discuss, learn, and draft together.

Submit your comment: Visit regulations.gov and search “HHS Health Sector AI RFI” or document number 2025-23641. You can submit electronically or by mail (addresses in the Federal Register notice).

Share this letter: If you know someone who cares about healthcare, children’s health, democratic participation, or the future of AI—pass this along.

The Larger Vision

Moonshot Press exists to ensure that life, liberty, and the pursuit of happiness aren’t just inspiring words—they’re lived realities for every American. That requires systems that work: healthcare that keeps people healthy, information that keeps people informed, and governance that keeps people empowered.

Project 2026 is our commitment to building those systems through citizen action. Not by waiting for institutions to fix themselves, but by showing up, doing the work, and demonstrating what’s possible when people take seriously their role as citizens.

The HHS RFI is one opportunity among many. But it’s a real one, with a clear timeline and legal weight. It’s a chance to practice democracy in its most practical form: engaging seriously with complex questions, offering evidence-based arguments, and insisting that policy serve the people it governs.

This is how change happens—not through single heroic moments, but through sustained collective effort. Not through rage or resignation, but through informed, purposeful participation.

We can build a healthcare system where everyone can get the care they need to live healthy, flourishing lives. But we can only build it together.

Will you join us?

With hope and determination,

The Moonshot Press Team

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On September 17, 1787, as the Constitutional Convention came to a close, Benjamin Franklin, one of the most revered founding fathers, walked out of Independence Hall and was approached by Mrs. Powel, the wife of the Philadelphia mayor. She asked him, "Doctor, what have we got? A republic or a monarchy?" Franklin famously replied, "A republic, if you can keep it."

This brief exchange has resonated through the centuries as a reminder of both the gift and the responsibility handed down by the framers of the U.S. Constitution. It encapsulates the fragile nature of a republic, where power is vested in the people rather than a monarch, but only if citizens are engaged and vigilant in maintaining it.

The Fragility of the Republic: Franklin’s Ominous Warning

Franklin's response, while hopeful, carries an ominous warning: the survival of the republic is not guaranteed. As he implied, keeping the republic requires active participation, responsibility, and engagement by its citizens. In times of increasing political polarization, like those we are currently experiencing, Franklin’s words have been invoked repeatedly, whether during the impeachment hearings for President Trump or in recent reflections by leaders like Supreme Court Justice Neil Gorsuch Senator Nancy Pelosi and the journalist Fareed Zakaria. Even former President Joe Biden referenced Franklin’s remark in his speech about the future of American democracy, underscoring the role of citizens in shaping that future.

But what does it truly mean to "keep" a republic in today’s world? Franklin’s remark was not merely about elections or periodic civic rituals—it was a call to ongoing engagement, accountability, and participation in the very machinery of governance. This poses a central question: how can citizens, often relegated to passive roles as consumers of government services, be empowered to take an active and sustained role in keeping the republic alive?

Public Opinion, Civic Engagement, and Political Agency

The Constitution did not come with a user’s manual. While it established a framework for governance, it left much of the responsibility for maintaining democracy in the hands of its citizens. Elections are only one part of the democratic process, and while voting is critical, civic engagement should not be confined to election cycles. Too often, citizens are passive consumers of government services, only interacting with the system when they cast their votes. Between elections, they are disengaged, with little opportunity or guidance to influence decisions that affect their daily lives.

In fact, one of the most underutilized and powerful checks on government that the founders, including James Madison, anticipated was public opinion. Madison understood that while institutional checks and balances could guard against government overreach and the dangers of factions, an engaged and informed public could serve as a vital corrective force. He envisioned a public that was involved in ongoing deliberation, shaping policies through reasoned debate and holding elected officials accountable.

However, modern media, while offering citizens unprecedented access to information, often amplifies division, misinformation, and partisanship, complicating the formation of a healthy public opinion. Moreover, many citizens lack the tools or frameworks to engage in the democratic process outside of elections.

The Need for a Citizen Toolbox

What is missing today is what Franklin might have hoped for—a citizen toolbox. A set of tools and frameworks that empower citizens to engage actively with their government, to be informed and deliberate participants in the political ecosystem. Such a toolbox would provide citizens with:

The Citizen Toolbox

A comprehensive suite of digital tools designed to enhance your role within the political ecosystem. These tools provide unprecedented opportunities to access information, mobilize for causes, and engage in deliberative dialogues that enrich democracy.

• Tracers: Analyze and assess how public services are delivered and their impact on the community.

• Data Tools: Leverage verifiable and reproducible data to elevate your arguments and understand policy impacts.

• Checklists: Navigate complex political processes with ease, ensuring you can act confidently and effectively.

• Ecosystem Tools: Utilize our "My Ecosystem" feature to gain a detailed view of your local, state, and federal political landscapes. This tool helps you understand the roles and influences of various political actors and institutions, empowering you to engage more effectively with your political environment.

Deliberative Platforms

Moonshot Press is proud to introduce platforms that facilitate meaningful dialogue and collective decision-making:

• The Citizen Brief: Dive into detailed discussions on social and political issues, providing a structured approach to understanding and solving complex challenges.

• The Case Presentation: Engage with a problem-solving format that addresses social and political challenges through collaborative public involvement.

• The Citizen Commission: A dynamic framework for ongoing dialogue and action, enabling citizens to tackle societal challenges head-on.Public Opinion as a Check on Government

In line with Madison’s thinking, public opinion should not just be seen as a reflection of political trends or media narratives; it should be an informed, deliberative force capable of shaping policy and government behavior. When citizens are equipped with the right tools, public opinion can serve as a critical check on government power, ensuring that it remains responsive to the needs and interests of the people. It prevents factions from taking over the discourse and safeguards against the erosion of democratic norms.

Franklin’s remark was not just a historical anecdote—it was a call to action, a challenge to each generation of citizens to take an active role in preserving the republic. As democracy faces new threats, from polarization to disinformation to disengagement, the path forward lies in equipping citizens with the tools and frameworks to actively engage in the political process.

Conclusion: The Power to Preserve Democracy is in Our Hands

As we reflect on Constitution Day, it is clear that the survival of the republic depends on more than just the electoral process—it requires sustained civic engagement, informed public opinion, and active political agency. The founders, particularly Madison and Franklin, understood the need for ongoing participation in governance beyond the ballot box. Franklin's words remain a powerful reminder that the responsibility for maintaining democracy lies in the hands of the people. But to "keep" the republic, citizens must be more than voters; they must be active participants in the democratic process, equipped with the tools to engage meaningfully with their government.

In this spirit, my effort is to provide a citizen toolbox—a set of resources and deliberative frameworks designed to empower citizens to take an active part in the political ecosystem. The future of the republic rests on our collective ability to cultivate informed, engaged, and empowered citizens. Only then can we truly say that we have "kept" the republic that Franklin and the framers entrusted to us.

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Introduction

Healthy societies, much like healthy individuals, need nurturing environments to thrive. The salutogenic paradigm, which focuses on promoting well-being rather than merely treating disease, can provide a unique perspective on the political beliefs and behaviors that contribute to a thriving democracy. This approach emphasizes the importance of resilience, empowerment, and meaning in both individual and collective life.

Central to the salutogenic model is the Sense of Coherence (SOC)—the idea that people thrive when they find life comprehensible, manageable, and meaningful. This article explores how understanding the SOC can help frame political beliefs and empower citizens to actively and positively participate in their communities. By fostering a stronger SOC, citizens can become more resilient, engaged, and committed to maintaining a healthy democratic society.

Understanding the Salutogenic Model in Politics

The salutogenic paradigm, developed by medical sociologist Aaron Antonovsky, aims to identify what keeps individuals and societies healthy, rather than just diagnosing problems. In a political context, this means focusing on what makes societies resilient, what fosters citizen engagement, and what helps people find meaning in their civic roles. By promoting health and well-being in political engagement, societies can cultivate a democracy that is dynamic, inclusive, and resistant to the forces of extremism, apathy, or authoritarianism.

The Sense of Coherence (SOC) is composed of three main components:

1. Comprehensibility: The extent to which individuals perceive their political environment as ordered, consistent, and understandable.

2. Manageability: The belief that they have the resources and tools to participate meaningfully in political processes.

3. Meaningfulness: The sense that their engagement in political life is important and worthwhile.

These three elements help frame the role of citizens within a democratic society and provide a pathway to cultivate more resilient political engagement.

How Salutogenesis Can Frame Political Beliefs and Citizen Roles

1. Comprehensibility: Making the Political Landscape Understandable

Democratic engagement is strengthened when citizens feel that their political environment is understandable and transparent:

• Access to Clear Information: Comprehensibility in the political context means having access to reliable, clear, and understandable information. Citizens need to understand how policies affect them, how decisions are made, and how the government functions.

• Education and Civic Literacy: A key part of enhancing comprehensibility is civic education. When people understand political processes, institutions, and their own rights, they are better equipped to engage. Civics classes in schools, community workshops, and public discussions can all play a role in making the political environment more accessible.

• Transparent Communication: Governments and institutions should prioritize transparent communication to foster trust and reduce the confusion that can lead to disillusionment or disengagement. When the political landscape feels coherent, citizens are more likely to believe that their participation matters.

By increasing the comprehensibility of the political environment, people can engage with more confidence, ultimately contributing to a stronger democracy.

2. Manageability: Ensuring Citizens Have the Tools to Engage

Citizens are more likely to participate in political life when they feel that they have the resources and opportunities to do so:

• Access to Participation Tools: To feel politically empowered, citizens need tangible opportunities for involvement. This might include voting access, opportunities to engage in public consultation processes, or the availability of platforms for direct political advocacy. Providing accessible avenues to engage makes the political system feel more manageable.

• Local Engagement Opportunities: Engagement at the local level often feels more manageable to citizens than national or global issues. Local governance opportunities, such as town hall meetings, community boards, or neighborhood initiatives, can serve as gateways for broader political engagement. These experiences help citizens build skills and confidence, making broader political participation more approachable.

• Support for Vulnerable Populations: A sense of manageability also requires support for those who face additional barriers to engagement—such as marginalized or economically disadvantaged groups. Providing equal access to information, creating accessible polling stations, and supporting grassroots initiatives that address community needs can ensure that all citizens feel capable of participating.

When citizens feel they have the resources and ability to influence political outcomes, they are more likely to take an active role in shaping their society.

3. Meaningfulness: Cultivating a Sense of Purpose in Political Engagement

Political engagement must also be meaningful for individuals to feel motivated to participate:

• Connection to Community: Meaningful political engagement often stems from a deep connection to one’s community. When citizens feel they are contributing to the well-being of their neighbors and future generations, their political actions feel more significant. Initiatives that highlight the impact of civic participation can help cultivate this sense of connection.

• Personal Empowerment and Collective Goals: Political engagement becomes more meaningful when individuals see how their efforts contribute to broader, collective goals. Encouraging citizens to participate in movements that align with their values—whether environmental, social justice, or local development—can help them find purpose in political actions.

• Recognition of Citizen Contributions: Governments and institutions should recognize and celebrate citizen contributions. When people feel that their actions are appreciated and have an impact, they are more likely to find their engagement worthwhile.

By making political participation meaningful, citizens are encouraged to see their role as a vital part of a greater collective effort, leading to more resilient and sustainable engagement.

A Salutogenic Approach to Strengthening Democracy

To build a resilient democracy, we need to foster a salutogenic environment that enhances citizens' sense of coherence. Here are some key approaches to applying the salutogenic paradigm to political engagement:

The First 1000 Days of Life 

The first 1000 days are critical for establishing the cognitive, emotional, and physical foundations essential for lifelong well-being and active citizenship. Through the salutogenic approach, which emphasizes promoting health by fostering a sense of coherence—making life's challenges comprehensible, manageable, and meaningful—we focus on providing proper nutrition, nurturing environments, and responsive care. By integrating individual assessments with community-informed support, this paradigm aims to create conditions that enable individuals to thrive and fully participate in a democracy of opportunity.

Civic Education and Transparent Governance

Investing in civic education can increase the comprehensibility of political processes. Education programs that teach about government structures, individual rights, and critical thinking will help create informed citizens. Transparent governance and clear communication from political leaders further support this effort by ensuring that citizens can understand decisions that affect their lives.

Ensuring Manageability Through Accessible Engagement

Creating an environment where citizens feel capable of engaging is crucial. This involves removing barriers to participation and providing resources that empower citizens to become active. Local-level engagement initiatives, support for marginalized communities, and easy access to political processes are key components of making the political landscape more manageable.

Cultivating Meaningful Participation

Citizens are most engaged when they feel that their actions have significance. By highlighting the impact of civic activities, providing opportunities to advocate for community values, and celebrating contributions, political engagement becomes more meaningful. This sense of purpose fosters a deeper commitment to the democratic process and increases the resilience of the political system.

Conclusion: Fostering a Healthier Democracy

A thriving democracy depends on active, informed, and empowered citizens. By applying the salutogenic paradigm to politics, we can focus on enhancing citizens' Sense of Coherence, making the political environment more understandable, manageable, and meaningful.

By ensuring that newborns have the needed biological, social and psychological factors to flourish, by promoting civic education, reducing barriers to engagement, fostering community connections, and celebrating meaningful contributions, we can create a resilient political culture where citizens feel motivated and capable of contributing to the democratic process. This approach not only strengthens individual well-being but also builds the foundation for a healthier, more inclusive, and participatory democracy—one that can withstand challenges and continue to grow.

Ultimately, a salutogenic approach to political engagement provides the tools needed for individuals and communities to thrive in their roles as active citizens, ensuring that democracy is not just a form of government, but a lived experience of collective empowerment and resilience.