Trump’s “Great Healthcare Plan” is Low on Details

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Policy objectives are broken into four major domains: Lowering drug prices, lowering insurance premiums, holding big insurance companies accountable, and maximizing price transparency.

President Trump, on January 15, 2026, announced The Great Healthcare Plan, calling on Congress to drive legislation that will lower the costs of healthcare and increase transparency for consumers.

The plan lacks specificity in how the President's laudable goals can be tailored into clean policies that deliver the desired outcomes. Policy objectives are broken into four major domains: Lowering drug prices, lowering insurance premiums, holding big insurance companies accountable, and maximizing price transparency.

Lowering Drug Prices

Prescription drug savings would be driven by codification of Most Favored Nation (MFN) deals. Through direct negotiations between the United States government and major pharmaceutical suppliers, consumer pricing would be established at a rate comparable to prices available in other countries on more drugs and classes of drugs. Some companies have already entered into voluntary agreements on pricing; codification of MFN would likely expand its use, creating consumer price caps on more medications.

The plan also indicates a transition of some current prescription medications to over-the-counter availability, with the promise of lower costs to consumers. The plan purports lower overall costs to consumers by increasing market competition and eliminating the need for doctor visits. While this transition could lower costs for some individuals, it is likely to increase costs for others with strong prescription and primary care coverages. Additionally, these moves could complicate access to medications for individuals with limited transportation options that currently access Rx options via mail. Ongoing access to newly-transitioned over-the-counter medications could mean shopping around among retailers to find the lowest price and learning new home-delivery services like InstaCart or DoorDash, for additional fees.

Lowering Insurance Premiums

This section of the plan introduces health savings accounts (HSA) to replace government funded subsidies paid to insurers, changes to Affordable Care Act cost sharing, and changes to the use of Pharmacy Benefit Managers (PBMs).

No policies are included to discuss how the termination of government funds currently sent to insurers to lower premiums for marketplace insurance plans would lower out-of-pocket costs for individuals. These funds would be diverted to individuals, likely in the form of deposits in an HSA, to pay for insurance that is no longer subsidized. The narrative implies that consumers would have more choice of available plans to buy with their newly-found government funded HSA. Sending money directly to people living across the country resonates with individuals more than sending funds to large insurers, though the reality is this further complicates the process for individuals seeking insurance. They would now need to pay part of the premiums with the HSA, then backfill with cash. Additionally, more people are likely to forgo insurance overall because of costs, even if they anticipate a large sum to be offset via their government funded HSA. For example: take a subsidized plan where a person was paying $200 a month for a mid-range coverage plan and the insurer was receiving $300 a month in subsidy for that same person; total costs at $500. Now, when the person is shopping for the same plan, assuming no increases in premiums (which are unlikely) the person is selecting the same plan at what seems like a $500 price tag. Seeing this change in cost and not having been read into how HSAs work or how they are eligible for cost-offsets, the person is likely to shop for a cheaper plan with less coverage or forgo insurance entirely.

Holding Big Insurance Companies Accountable and Maximize Price Transparency

The plan contends that the insurance industry hides fees and bundled services behind complicated industry jargon intended to confuse consumers and obfuscate costs. The idea is, by requiring a 'plain English insurance' standard and requiring insurance companies to disclose how revenues are allocated along with percentages of claims paid vs denied, consumers will be better informed to make choices that benefit their wellbeing and bottom line. Providers participating in Medicare and Medicaid would also be required to "prominently post their pricing and fees in their place of business," per the plan. In announcing the plan via video, President Trump states that, 'sunlight is the best disinfectant' reinforcing the assumption that more information is better for consumers.

For these proposals to provide value to the people, transparency and accountability will hinge on everyday consumers of healthcare investing time and energy in research and comparison shopping across the healthcare sector. Additional information about costs of care and services for individuals will matter little if their insurer is still picking up the bill. These policies, if enacted, will increase the burden on providers to maintain publications of rates for specific services and could lead to individuals seeking healthcare through unaffiliated organizations, resulting in more complicated health record access and less overall healthcare coordination.

In Closing

Notably missing from the plan was any interest in improving the quality of and access to healthcare for people in the United States. The plan's central goal of decreasing the costs of healthcare for individuals is not balanced by the need for ongoing quality improvement, simplification, and availability of coverage and services. Additionally, for many of the proposed policies, if enacted, they aren't likely to drive the intended outcomes but rather could be ripe with unintended consequences making the healthcare industry more, not less, complicated for everyday people to engage and navigate.