President Donald Trump on Thursday unveiled a new healthcare framework, titled the “Great Healthcare Plan,” calling on Congress to immediately codify a series of executive actions aimed at reducing prescription drug prices and restructuring federal insurance subsidies.
The proposal arrives as the federal government faces a looming deadline over expired Affordable Care Act (ACA) tax credits and rising concerns over healthcare affordability.
The White House is positioning the package as a comprehensive agenda to “lower healthcare costs all throughout the healthcare system,” according to administration officials. White House Press Secretary Karoline Leavitt urged lawmakers to “immediately take up” the plan.
“These are commonsense actions that make up President Trump’s Great Healthcare Plan, and they represent the most comprehensive and bold agenda to lower health care costs to have ever been considered by the federal government,” Leavitt told reporters on Thursday. “Congress should immediately take up President Trump’s plan and pass it into law.”
A central pillar of the plan involves a fundamental shift in how federal subsidies are distributed. Trump has proposed ending taxpayer-funded subsidy payments directly to insurance companies, opting instead to send those funds directly to eligible Americans.
“The government is going to pay the money directly to you,” Trump stated in a video released by the White House. “It goes to you, and then you take the money and buy your own health care. Nobody has ever heard of that before, and that’s the way it is.”
While the administration offered few specific details on the distribution mechanism, officials suggested the funds could be deposited into Health Savings Accounts (HSAs) to cover out-of-pocket costs like deductibles and copays. Dr. Mehmet Oz, Administrator of the Centers for Medicare & Medicaid Services (CMS), argued this would allow citizens to “use that money more wisely.”
The plan also seeks to codify the “most favored nations” drug pricing initiative, which instructs pharmaceutical companies to align U.S. drug prices with the lower costs found in other developed nations. This builds upon previous executive orders and voluntary negotiations with major drugmakers.
Furthermore, the “Great Healthcare Plan” emphasizes price transparency through several new requirements.
Insurers would be required to publish rate and coverage comparisons upfront without industry jargon. Providers and insurers accepting Medicare or Medicaid must “prominently post their pricing and fees in their place of business.” Insurance companies would be forced to publish the percentage of claims they reject, average wait times for care, and the ratio of overhead costs to medical claims.
The rollout occurs against a volatile political backdrop. Enhanced ACA subsidies, which millions of Americans relied on to lower premiums, expired at the end of 2025. While the House passed a three-year extension on January 8 with the help of 17 rebellious Republicans, the measure has stalled in the Senate.
Administration officials noted that while Trump has suggested a veto of the ACA subsidy extension, the “Great Healthcare Plan” is not intended to “close the door” on negotiations. Instead, it serves as a framework to move past what Dr. Oz described as “lazy lawmaking” that merely throws taxpayer money at systemic issues rather than addressing “root causes”.
However, the plan has met immediate resistance from Democrats and policy experts. Senator Ron Wyden, ranking member of the Senate Finance Committee, dismissed the announcement as “empty promises,” stating that it follows a pattern of the president failing to deliver on lower costs.
Policy analysts have questioned the feasibility and potential impact of the proposal. Cynthia Cox, director of the ACA program at KFF, warned that shifting subsidies from insurers to individuals could trigger a “death spiral” in the insurance marketplace. Without direct premium credits, healthier consumers might leave the market, potentially leaving those with pre-existing conditions without affordable, comprehensive options.
“When it comes to health reform, the devil is in the details, and this is very light on details,” Cox noted. She added that price transparency, while helpful, is unlikely to be a “magic bullet” since most patients do not “shop” for care during medical emergencies.
Art Caplan, head of the medical ethics division at NYU Grossman School of Medicine, echoed these concerns, calling the idea of consumers as “savvy shoppers” in healthcare a “broken idea”. He argued that the average consumer lacks the time or expertise to compare prices during critical events like car accidents or premature births.
As Congress prepares for a week-long recess, the path forward for the “Great Healthcare Plan” remains uncertain. The administration is not seeking to pass the plan through the reconciliation process, meaning it would likely require 60 votes in the Senate to overcome a filibuster.
While some provisions—such as cracking down on pharmacy benefit manager (PBM) “kickbacks”—may find bipartisan support, the broader overhaul faces a steep climb in a deeply divided legislature. For now, the White House continues to frame the plan as a “simple, transparent, and affordable” alternative to the current system.