{"id":10979,"date":"2026-01-26T12:30:55","date_gmt":"2026-01-26T12:30:55","guid":{"rendered":"https:\/\/medical-article.com\/?p=10979"},"modified":"2026-01-26T12:30:55","modified_gmt":"2026-01-26T12:30:55","slug":"what-is-included-in-trumps-great-healthcare-plan","status":"publish","type":"post","link":"https:\/\/medical-article.com\/?p=10979","title":{"rendered":"What is included in Trump\u2019s \u201cGreat Healthcare Plan\u201d?"},"content":{"rendered":"

President Trump unveiled \u201cThe Great Healthcare Plan<\/a>\u201d on January 15, 2026, calling on Congress to reduce prescription drug prices, lower insurance premiums, and increase healthcare price transparency. The plan proposes four main components: <\/p>\n

codifying Most-Favored-Nation (MFN) drug pricing<\/strong> agreements that the administration has negotiated with 16 pharmaceutical manufacturers, targeting prices at the lowest international levels;Redirecting Affordable Care Act (ACA) exchange plan subsidies <\/strong>as direct payments to consumers via Health Savings Accounts (HSA) <\/strong>rather than to insurance companies; Restoring Cost-Sharing Reduction (CSR)<\/strong> funding for ACA plans; and Mandating insurance and provider price transparency,<\/strong> including claims denial rates and medical loss ratios.<\/p>\n

Some more details are available at this fact sheet<\/a>.<\/p>\n

The fiscal impact remains highly uncertain. The Committee for a Responsible Federal Budget<\/a> estimates that cost-reducing provisions\u2014primarily CSR funding restoration and PBM reforms\u2014could save approximately $50 billion over 10 years. However, if the subsidy restructuring component extends beyond enhanced subsidies to include base ACA premium assistance, costs could reach $350 billion over the same period. The net budgetary effect ranges from $50 billion in deficit reduction to $300 billion in deficit increase depending on implementation design. Notably, CBO has not scored the proposal<\/strong>, as no legislative text exists.<\/a><\/p>\n

It is unclear how much of the Great Healthcare Plan will actually be implemented in practice. Current law prohibits using HSAs to pay insurance premiums\u2014only qualified medical expenses such as deductibles and copayments. Without Congressional action to amend the Internal Revenue Code, the \u201cdirect payments to consumers\u201d component cannot address premium affordability, which is the immediate crisis facing ACA enrollees after enhanced subsidies expired December 31, 2025. Additionally, the MFN drug pricing approach relies on voluntary manufacturer participation through CMMI demonstration models (GENEROUS for Medicaid, GLOBE\/GUARD for Medicare Parts B\/D \u2013 see my post here<\/a>) rather than statutory mandates. Previous attempts to impose mandatory MFN pricing were blocked by federal courts in 2020<\/a>, raising questions about enforcement authority if manufacturers decline to participate voluntarily.<\/p>\n

As of January 26, 2026, Congress has not introduced legislation to implement the plan\u2019s core provisions. Lawmakers did pass PBM reforms<\/strong> in appropriations legislation (H.R. 7148<\/a>) last week, delinking PBM compensation from drug prices and prohibiting Medicaid spread pricing. However, Congress notably excluded CSR funding\u2014the single largest deficit-reducing component\u2014from the final FY2026 appropriations package. Enhanced ACA subsidies were also not extended, leaving 20+ million Americans facing premium increases averaging 114%. This disconnect between the administration\u2019s stated priorities and Congressional action suggests significant political obstacles to implementation.asge+6<\/a><\/p>\n

What are others saying about the plan? KFF CEO Drew Altman<\/a> describes as \u201chealth policy by transaction\u201d rather than comprehensive reform. The administration has implemented several executive actions\u2014the TrumpRx.gov direct-to-consumer platform expected to launch January 2026, voluntary MFN agreements with manufacturers receiving three-year tariff exemptions, and CMMI demonstration models\u2014that may produce tangible but modest results for specific populations. Morningstar reports<\/a> that multiple policy analysts characterized the announcement as \u201csparse on details,\u201d with Raymond James noting \u201cthere is no legislative path forward for much of it\u201d and Spencer Perlman of Veda Partners concluding the policies \u201cstand little chance of being enacted by the current Congress\u2026\u201d<\/p>\n

What do you think of the Great Healthcare Plan?<\/a><\/p>","protected":false},"excerpt":{"rendered":"

President Trump unveiled \u201cThe Great Healthcare Plan\u201d on January 15, 2026, calling on Congress to reduce prescription drug prices, lower insurance premiums, and increase healthcare price transparency. The plan proposes four main components: codifying Most-Favored-Nation (MFN) drug pricing agreements that the administration has negotiated with 16 pharmaceutical manufacturers, targeting prices at the lowest international levels;Redirecting…<\/p>\n","protected":false},"author":0,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-10979","post","type-post","status-publish","format-standard","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/10979"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=10979"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/10979\/revisions"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=10979"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=10979"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=10979"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}