President Donald Trump has announced a new healthcare framework, the “Great Healthcare Plan,” seeking to redirect funds to consumers, lower prescription drug prices, and restore cost-sharing subsidies. The plan arrives as insurance premiums surge and lawmakers remain divided on how to respond to expiring Affordable Care Act (ACA) subsidies.
The proposal, outlined Thursday, does not provide legislative text or a detailed path forward in Congress, but it revives several initiatives from Trump’s previous term and builds on newer measures introduced in 2025. The announcement comes at a moment when millions of Americans face higher healthcare bills and limited options, just as the ACA open enrollment period has ended.
New Framework Prioritizes Direct Payments and Drug Pricing Reforms
The centerpiece of the Great Healthcare Plan is a strategy to send federal funds directly to individuals, bypassing traditional healthcare intermediaries such as insurance companies. Trump said the funds would go into personal health savings accounts, allowing consumers to purchase their own coverage and services. According to a January 15 statement from the White House, the initiative is designed to “put more money in your pocket” while cutting out “big insurance companies, big pharma and special interest groups.”
A key component of the proposal is its drug-pricing mechanism, based on a “most-favored nation” policy. This model ties the prices Americans pay for prescription drugs to the lowest rates paid in other developed countries. Trump claimed the plan could reduce prices “by 80, 90% in some cases,” and said the changes would begin taking effect immediately through a platform called TrumpRx.gov.
The proposal also pledges full funding for the ACA’s cost-sharing reduction program, a subsidy previously terminated during Trump’s first term. Analysts say restoring these payments could reduce premiums on ACA marketplace plans by up to 15%, according to The Associated Press. At the same time, critics noted that the plan lacks detail on eligibility, funding levels, or implementation timelines, and the administration did not clarify how the funds would be allocated or regulated.
Critics Highlight Lack of Details and Political Uncertainty
Despite its scope, the Great Healthcare Plan has sparked skepticism across party lines, largely due to the absence of a comprehensive legislative proposal or congressional support. As reported by The Washington Post, the plan does not include new provisions to expand coverage or address the complexity of the healthcare system. Administration officials referred to it as a “broad architecture” and said further legislation would be needed to realize the goals.
Senate Majority Leader John Thune described the pricing transparency aspects of the proposal as “no-brainers” but declined to discuss specific policy language. Democrats, meanwhile, criticized the plan as an inadequate response to rising premiums and the recent lapse in federal ACA subsidies. Senator Elizabeth Warren called the proposal “a Band-Aid for the full-blown health care crisis” and accused Trump of attempting to shift blame for rising costs.
The rollout comes just weeks before key midterm elections, with polls showing healthcare remains one of voters’ top concerns. Trump has encouraged Republican lawmakers to treat healthcare as a priority issue, saying earlier this month that “It’s never been our issue. It should be our issue”
In parallel with the announcement, the White House launched a new website, GreatHealthcare.gov, to provide more information. The administration says additional tools and updates will become available by the end of the month. Until then, the proposal’s future (and its ability to influence policy) remains uncertain.
