President Donald J. Trump is calling on Congress to pass what the White House is branding as “The Great Healthcare Plan,” a wide-ranging proposal the administration says is designed to lower healthcare costs for Americans through reduced prescription drug prices, lower insurance premiums, stricter insurance-company disclosure requirements, and expanded price transparency.
The plan, promoted on the White House website this month, is positioned as a sweeping alternative to the current system shaped by the Affordable Care Act, commonly known as Obamacare.
But while the proposal contains several ideas likely to resonate with voters across the political spectrum — including lower drug prices and greater transparency — it also leaves major policy details unclear and raises concerns about how the changes would affect Americans who rely on strong coverage rules and subsidies under current law.
What the White House says the plan will do
According to the administration, the Great Healthcare Plan is built around four main goals: lowering drug prices, lowering premiums, holding big insurance companies accountable, and maximizing price transparency.
Lowering drug prices
The plan calls for codifying a “Most-Favored-Nation” pricing approach intended to give Americans the same low prescription drug prices paid in other countries.
The White House says this would build off actions taken during Trump’s first term, including efforts to make insulin more affordable, as well as voluntary negotiations following a recent executive order aimed at lowering drug prices. The plan states that voluntarily negotiated deals with federal health agencies would be “grandfathered in.”
The plan also proposes allowing more verified safe pharmaceutical drugs to be available over the counter, which the administration says would reduce healthcare costs, increase consumer choice, and lower the need for expensive doctor visits.
Lowering insurance premiums
To lower premiums, the plan proposes ending billions of dollars in taxpayer-funded subsidy payments to large insurance companies and instead sending that money directly to eligible Americans to help them purchase health insurance “of their choice.”
The plan also calls for funding a cost-sharing reduction program, which the administration says would save taxpayers at least $36 billion and reduce the most common Obamacare plan premiums by more than 10%, citing analysis from the Congressional Budget Office.
Another major focus of the plan is cutting so-called “kickback” costs by ending pharmacy benefit manager (PBM) practices the administration says increase health insurance costs.
Holding insurers accountable
The plan includes a set of new disclosure requirements for insurers, including a “Plain English Insurance” standard requiring health insurance companies to publish rate and coverage comparisons up front, in plain language.
It also calls for requiring insurers to publish what percentage of their revenue goes toward claim payments versus overhead and profits, as well as displaying claim denial rates and average wait times for routine care.
Maximizing price transparency
Under the proposal, healthcare providers and insurers that accept Medicare or Medicaid would be required to prominently post pricing and fees inside their place of business.
Major issues remain unresolved
Despite the plan’s marketing as a comprehensive cost-cutting reform, key questions remain unanswered — especially when compared to the more detailed legal and regulatory framework established by the Affordable Care Act.
Key details are missing
The administration’s summary does not clearly explain how the plan would work at the legislative level, how eligibility would be determined for direct payments, or what guardrails would exist to prevent insurance markets from shifting toward lower-cost plans that provide weaker coverage.
That matters because under the Affordable Care Act, consumer protections and benefit requirements are built into the structure of the law, including standards for what must be covered and how insurance companies can treat certain patients.
The “send money directly” approach could shift risk to consumers
One of the most consequential parts of the proposal — sending assistance directly to individuals rather than structuring subsidies through the marketplace — could have major implications for affordability and coverage stability.
Healthcare policy experts have long warned that voucher-style or direct-payment models can fall behind the true cost of insurance over time, leaving families responsible for rising premium gaps and higher out-of-pocket costs.
If the payment amount fails to keep pace with the market, middle-class families and people with ongoing healthcare needs could face larger financial exposure.
Price transparency alone does not prevent surprise bills
The proposal’s emphasis on posting prices is likely to appeal to consumers frustrated with opaque billing practices.
However, in practice, healthcare costs in the United States are often determined by complex factors such as negotiated insurance rates, network status, medical coding, and facility billing practices — meaning posted prices may not reflect what patients ultimately pay.
Drug pricing reform may face industry and legal hurdles
The plan’s “Most-Favored-Nation” drug pricing approach is another area that could face significant pushback from pharmaceutical companies, legal challenges, and implementation challenges, depending on how Congress structures the policy.
Even if the concept is popular with consumers, lowering prices through international price benchmarks can trigger intense lobbying and procedural roadblocks in Washington.
A major political fight ahead
The Affordable Care Act remains one of the most politically divisive laws in modern U.S. history. While Trump’s plan is framed as a cost-cutting alternative rather than a direct repeal effort, its success would likely depend on whether Republicans can unify around a bill detailed enough to pass Congress — and whether moderate lawmakers and voters believe it protects patients from coverage losses.
For now, the White House has cast the Great Healthcare Plan as a blueprint for “simple, transparent, affordable” healthcare. But until the proposal is backed by legislative text and clarified protections, it remains unclear whether the plan would lower costs without creating new risks for millions of Americans.
Texas Reporter 