The Trump administration unveiled a plan Thursday intended to address rising health care costs across the United States, with the announcement coinciding with the conclusion of Affordable Care Act (ACA) open enrollment in most states. Despite its ambitious branding as “The Great Healthcare Plan,” the newly released outline reiterates many concepts previously championed by President Donald Trump, while leaving several key details unclarified.
Positioned as a comprehensive strategy to curb medical expenses, the proposal encompasses efforts to reduce prescription drug prices, reallocate federal subsidies to benefit consumers directly rather than insurers, and introduce stricter requirements for price transparency.
The proposal emerges amid ongoing efforts in Congress, where Republicans are attempting to negotiate a legislative extension for boosted ACA tax credits. These credits, lapsed at the end of the previous year, have led to notable hikes in health insurance premiums for millions. Hopes for a swift resolution are fading as the Senate’s imminent recess limits the legislative window.
Trump noted that the plan involves direct deposits into health savings accounts, giving beneficiaries the means to offset costs such as deductibles and copayments. However, this and related provisions would require congressional approval, generating doubts over the plan’s timeline and viability.
During a briefing with reporters, administration representatives declined to clarify key aspects of the plan, including the mechanics of distributing payments directly to individuals, the prospective amounts involved, or eligibility criteria.
Skepticism also remains among health policy experts. One of them questioned the effectiveness of sending payments directly to consumers. He warned that consumers could easily be exploited and that most lack the opportunity or expertise to make price comparisons in emergencies.
As for ACA tax credits, it applies directly to a person’s monthly premiums, making coverage more affordable from the outset. Without these subsidies, many individuals could find premiums unaffordable, destabilizing insurance markets and reducing coverage options—particularly for those with pre-existing health conditions, according to health policy expert Cynthia Cox.
Despite introducing the new framework, administration officials indicated negotiations to renew enhanced subsidies remain ongoing. The House of Representatives has recently approved a three-year extension of the credits while the Senate drafts its own version. However, President Trump has hinted at the possibility of vetoing any extension.
Another element of Trump’s health agenda is the introduction of TrumpRx, a direct-pay prescription drug platform set to launch later this month. Still, industry analysts have raised questions about the platform’s impact.
They point out that most insured customers already secure lower drug prices through existing coverage, and that many drugs on the platform either have cheaper generic alternatives or are only used by limited patient groups.
The administration has pressed Congress to move quickly on legislative action, contending that its plan would bring meaningful relief to Americans burdened by what it refers to as the “Unaffordable Care Act,” Trump’s recurring critique of the ACA’s high costs.
