President Trump on Thursday released the outline of a new healthcare plan that largely repackages several familiar proposals aimed at lowering insurance premiums and prescription drug prices under a new title: “The Great Healthcare Plan.” You can be certain you’ll be hearing that name repeatedly as part of Trump’s election-year affordability pitch.
“If this plan is put in place, every single American who has health care in the United States will see lower costs as a result,” White House press secretary Karoline Leavitt told reporters at a daily news briefing.
Trump’s framework stops well short of a comprehensive overhaul of the U.S. healthcare system and is light on details — you could call it “concepts of a plan.” It would do little to address rising costs in employer-based plans or cut out-of-pocket costs for millions of Americans. “The proposal,” STAT News notes, “would not reshape the structure of Medicare, Medicaid, or the health insurance plans people get through their jobs. Hospitals and doctors would not cede pricing power.”
It could, however, undermine the Affordable Care Act. Trump’s outline “includes some ideas with bipartisan support, like more price transparency and regulating pharmacy benefit managers,” Larry Levitt, executive vice president for health policy at KFF, a healthcare research non-profit, posted on X. “But, they’re wrapped in partisan proposals that would undermine the ACA.”
Trump’s plan, as outlined by the White House, is centered on four pillars aimed mostly at the pharmaceutical and insurance industries.
* Lowering prescription drug prices: Trump’s plan calls on Congress to codify his deals requiring drugmakers to offer Americans “most-favored nation” pricing that matches lower prices in similar countries. Some Republicans have opposed that proposal, arguing that it goes against the free-market principles of the GOP.
Trump also proposes to make more pharmaceuticals available over the counter if it’s safe to do so.
* Lowering insurance premiums: Trump continues to press lawmakers to shift billions of dollars in funding that have been used for ACA subsidies into direct payments for eligible Americans to use in shopping for their insurance plans. “President Trump is suggesting here that people could use government subsidies to buy insurance that doesn’t comply with ACA rules, including coverage of pre-existing conditions,” Levitt wrote. “That could lower costs for healthy people, but send the ACA marketplace into a death spiral.”
Trump’s proposal also calls for the reintroduction of a “cost-sharing reduction” program under the ACA that was ended in 2017, during his first term. The White House points to a Congressional Budget Office estimate that the plan would save $36 billion while lowering premiums on so-called silver-level Obamacare plans — but experts note that premiums for bronze and gold plans would likely rise.
Trump also called for ending payments from pharmacy benefit managers to the middlemen who help employers choose benefit plans, which the president called “kickbacks.” That proposal falls short of bipartisan calls for a more severe crackdown on pharmacy benefit managers.
* Holding big insurers accountable: Trump wants insurance giants to post rate and coverage comparisons in plain English and provide details about the profits they make from premiums and how often they deny care and reject claims.
* Increasing transparency: Trump’s plan emphasizes increased price transparency requirements for healthcare providers and insurers so that patients can more easily “shop for a better deal or better care.” Such efforts at increased transparency have both potential and limitations, according to one recent analysis by the Brookings Institution, a D.C. think tank, which noted that availability of pricing data does not guarantee that patients can access the information or use it effectively. “Without accompanying tools, incentives, and systems that enable patients, especially insured ones, to act on pricing data, the reach of transparency will remain narrow,” the Brookings report concluded.
In announcing his repackaged plan, Trump called on Congress to quickly pass his framework — a highly unlikely proposition. “We have to do it right now so that we can get immediate relief to the American people,” he said.
It’s not clear who, if anyone, might be looking to turn Trump’s framework into legislation. It’s not clear if Republicans, long divided on healthcare issues, can coalesce around Trump’s outline. And Democrats were quick to pan the president’s plan, making it even less likely that it can become law.
“Time and again, Donald Trump has made empty promises to the American people about lowering their health care costs, and today’s announcement is no different,” said Sen. Ron Wyden of Oregon, the top Democrat on the Senate Finance Committee. “The Republican health care agenda is all about making your healthcare cost more and letting giant corporations decide if and when you get healthcare.”
Meanwhile, a bipartisan group of senators continues to work on a compromise deal to extend the expired Affordable Care Act subsidies, though efforts to announce an agreement this week were derailed by continuing differences.
The bottom line: Trump’s plan might not get far in Congress — and it might not have a major effect if it does — but the announcement itself has already delivered Trump and the White House a valuable political win: a slew of favorable news headlines that say something along the lines of “Trump Unveils Health Care Affordability Plan” and “Trump Lays Out New Framework to Address Health Costs.”