President Donald Trump on Thursday unveiled his long-awaited plan to make health care more affordable for Americans.
The proposal, called the „Great Health Care Plan,” would send money directly to consumers to buy insurance, fund a cost-sharing reduction program under the Affordable Care Act and end reimbursements by pharmacy benefit managers to middlemen.
It would also codify the „most favored nation” cheaper drug deals that Trump has signed with pharmaceutical companies and make it possible to buy more prescription drugs over the counter.
The White House said in a statement that the „Great Care Plan” will „lower prescription drug prices, reduce insurance premiums, hold large insurance companies accountable and increase price transparency in America’s health care system.”
But the plan is short — Thursday’s release is just one page — and details are unclear.
It also includes a number of policies that experts aren’t sure will increase health care costs.
That includes sending money directly to consumers to buy insurance, a popular solution among conservatives to improve plans for this year’s Affordable Care Act.
in 2026 Premiums for ACA plans have doubled on average since the Dec. 31 deadline. more generous subsidies for insurance ended. The president lamented the subsidies, which led to a record number of inclusions in ACA plans as handouts to insurance companies.
„I want to end this blatant fraud and put the extra money directly into a health care savings account in your name, and you go out and buy your health care and make a lot of money,” Trump said in a video announcing the plan.
But these health savings accounts, or HSAs, are currently limited to high deductibles for bronze and catastrophic plans in the ACA exchanges, so only a fraction of enrollees would benefit from an infusion of federal dollars.
Also, money in an HSA cannot be used to pay monthly premiums.
70% of experts polled by the Cornell Center for Health Policy in December said replacing increased ACA subsidies with HSA contributions would significantly worsen health care affordability.
The „big health care plan” would also fund the cost-sharing reduction program for ACA plans. Cost-sharing reductions are another help in the ACA’s exchanges, which help insurers finance health care costs for low-income consumers. The government has historically supported this through annual payments to health insurers.
But cost-sharing cuts have been on hold since 2017, when the Trump administration decided to end them after a court case over the legality of the payments.
Now Trump wants to bring them back. Funding the cost-sharing reduction program would save taxpayers „at least” $36 billion and reduce ACA premiums by more than 10 percent, the White House said, citing estimates from the Congressional Budget Office.
The Great Health Care Plan also requires insurers to make rate and coverage comparisons upfront on their websites in „plain English” to make it easier for consumers to shop for plans.
Insurers should also publish the percentage of medical claims denied and the average wait time for routine care.
In addition, companies should disclose how much revenue is used to pay medical claims compared to expenses and profits.
Insurers already report this breakdown in quarterly financial disclosures using a metric called the medical loss ratio.
Finally, any provider or insurer participating in Medicare or Medicaid would have to „prominently post” its pricing and fees at its place of business, the plan says.
The focus on price transparency is not new to Trump, who has argued for both of his terms that health care costs would drop dramatically if only consumers knew the cost of medical care.
In Trump’s first term, CMS completed two price transparency regulations requiring insurers and providers to share price data, but compliance has been poor and there is little evidence that the rules have changed affordability.
Still, with the „Great Health Care Plan” in place, the U.S. „will have maximum price transparency, and costs will come down incredibly,” Trump said in a video Thursday. „I urge Congress to pass this system into law immediately.”
The release of the actual plan, while unclear, comes as a bit of a surprise since Trump and his top healthcare officials spent their first term promising a healthcare plan that would replace the ACA. Nothing has been confirmed.
Still, conservatives are cornered on health spending. Last year, the party refused to extend increased subsidies for ACA plans, allowing the 20 million Americans in ACA exchanges to face steep premium increases. Given the popularity of the subsidies, Republican leaders are concerned that their stance could be punished in the November midterm elections.
But America’s affordability crisis extends far beyond the ACA.
Costs are also rising in other insurance markets as Americans use more medical care and treat more chronic conditions. Meanwhile, the cost of care has also risen due to the inflationary impact of Trump’s tariff policies, medical workforce shortages, provider consolidation and other factors.