Key takeaways:
- The “Great Healthcare Plan” aims to lower drug costs and hold insurance companies accountable.
- Experts said the plan is vague and questioned how it will be implemented.
President Donald J. Trump announced a health care framework on January 16, 2026, that he said will lower drug prices and insurance premiums and hold insurance companies accountable by improving price clarity. He called on Congress to pass the framework into law “without delay.”
The “Great Healthcare Plan” aims to lower drug costs and hold insurance companies accountable.Image: Adobe Stock
“Rather of putting the needs of big corporations and special interests first, our plan finally puts you first and puts more money in your pocket,” Trump said in a video. “It’s called the ‘Great Healthcare’ because it’s great health care at a lower price.”
What the plan proposes
According to a White House fact sheet, the “Great Healthcare Plan” proposes codifying the “moast favored nation” deals that would lower drug prices based on what other countries pay.Trump noted these prices could decrease by 80% to 90%. This concept aims to leverage the purchasing power of the U.S. government by tying domestic drug prices to the lower prices paid in other developed nations, a strategy designed to directly reduce costs for American consumers.
The plan also seeks to expand access to over-the-counter (OTC) medications, making more pharmaceutical drugs readily available without a prescription. This initiative aims to lower healthcare costs and reduce the burden on the healthcare system by eliminating the necessity for costly and time-consuming doctor’s visits for certain medications. This approach promotes consumer convenience and potentially unlocks cost savings.
A core component of the “Great Healthcare Plan” centers on increasing accountability for insurance companies. The proposal mandates a “Plain English” requirement,compelling insurers to publish easily understandable rate and coverage comparisons on their websites,avoiding complicated industry jargon. This transparency initiative is intended to empower consumers to make informed decisions about their health insurance plans.
Moreover, insurance companies will be required to publicly disclose the proportion of their revenue allocated to claims payments versus administrative costs and profits. They must also publish data on the percentage of claims denied and average wait times for routine care. As Trump succinctly stated, “Simply put, you will be able to watch the scam.” This heightened transparency seeks to unveil potentially exploitative practices within the insurance industry and drive fairer pricing.
The plan extends price transparency measures to healthcare providers, requiring any provider or insurer accepting Medicare or Medicaid to publicly display their fees and pricing in their place of business. This change will allow patients to comparison shop and make informed decisions about their healthcare choices, potentially driving down costs through market competition.
Shifting away from conventional subsidy models, the Great Healthcare Plan proposes to provide financial assistance directly to eligible Americans, enabling them to purchase the health insurance plan of their choice. “The government is going to pay the money directly to you,” Trump emphasized. “It goes to you,and then you take the money and buy your own health care.” This approach represents a significant departure from the current system, placing greater control in the hands of individuals.
Though, a similar plan previously proposed by Republicans faced rejection in the Senate in December 2025 last month. That plan centered around the creation of new health savings accounts (HSAs). Concerns were raised that HSAs alone wouldn’t be sufficient to cover the healthcare expenses for many Americans. Together,the Senate also dismissed Democratic legislation aimed at extending Affordable Care Act (ACA) subsidies. A KFF report indicates that the lapse of these enhanced premium tax credits, coupled with rising premiums, is projected to increase out-of-pocket costs by over 75% on average.
Reactions from experts
The unveiling of Trump’s plan prompted a range of reactions from healthcare experts, with many voicing concerns about its feasibility and potential impact.
Cynthia Cox, senior vice president and director of KFF’s Program on the ACA and director of the Peterson-KFF Health System tracker, observed that several provisions outlined in the “Great Healthcare Plan” already exist within the framework of the ACA.“for example, the ACA as implemented includes public data on claims denials and insurer overhead, and ‘plain-English’ insurance coverage summaries,” she noted. “Additionally, the first Trump governance used ACA authority to require hospitals and insurers to reveal prices.”
Cox also pointed out ambiguities regarding the direct payment component of the plan. “It’s not entirely clear from the summary exactly what is meant by the proposal to ‘send the money directly to the American people,’” she stated. “Is it only the enhanced premium tax credit dollars that would be converted to a savings account, or are other taxpayer subsidies included in the ‘extra’?” she questioned, adding, “Would the funds be limited to out-of-pocket costs only or be used for premiums?”
A key concern raised by experts centers on the absence of explicit protections for individuals with pre-existing conditions, who could potentially face higher premiums. according to Cox, “without knowing more, it is impossible to say what the implications would be” for this vulnerable population.
Jason M. Goldman, MD, MACP, President of the American College of Physicians (ACP), expressed the association’s encouragement regarding the administration’s focus on lowering drug prices and increasing price transparency. However, he cautioned that funding hsas “is not a substitute for affordable extensive insurance coverage provided by ACA-compliant plans that guarantee coverage for recommended preventive services and ensure coverage for patients when they are sick.” He stressed, “Increasing funding for HSAs should supplement, not supplant the enhanced premium tax credits for ACA marketplace plans.”
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