On the final day to enroll in Reasonably priced Care Act (ACA) medical health insurance plans in most states, President Donald Trump offered his personal concepts for a well being care plan that left some well being coverage specialists that spoke to ABC Information with unanswered questions.
Trump has lengthy been requested for a well being care plan amid sustained criticism of the ACA, which was signed into legislation by President Barack Obama. “The Nice Healthcare Plan” presents a proposal to shift authorities insurance coverage subsidies on to customers by way of well being financial savings accounts and reap the benefits of his “most favored nation” drug worth initiative.
“My plan would cut back your insurance coverage premiums by stopping authorities payoffs to massive insurance coverage corporations and sending that cash on to the folks,” Trump stated in a video asserting the plan.
Nevertheless, the video and one-page truth sheet posted on the White Home web site had been mild on specifics about how a lot would really go to Individuals or how a lot funding the plan would require or how the funds can be distributed.
Dr. Sachin Jain, a former official within the Division of Well being and Human Companies throughout the Obama administration, acknowledged that it is a “fairly massive step” for Trump to articulate well being care as a serious precedence throughout his second time period.
President Donald Trump speaks throughout an occasion to advertise funding in rural well being care within the East Room of the White Home, Jan. 16, 2026, in Washington.
Alex Brandon/AP
Jain, who’s now the president and CEO of SCAN Group and SCAN Well being Plan, a not-for-profit Medicare Benefit supplier, instructed ABC Information “well being care is one among these areas the place the satan is at all times within the particulars” when it comes to what adjustments could possibly be applied.
Except for reducing drug costs by way of most-favored nation offers and slicing again on insurance coverage subsidies, the plan proposes a cost-sharing provision that the Congressional Price range Workplace estimates would cut back most Obamacare premiums by 10%.
The plan additionally proposes to carry insurance coverage corporations accountable with a “Plain English” normal and institute pricing necessities for suppliers who settle for Medicare and Medicaid to “prominently publish their pricing and charges.”
Trump urged Congress to “go this framework into legislation at once.”
Some provisions could have ‘nearly no impact’
Some well being coverage specialists imagine with only a one-page truth sheet that there is not any method to inform how impactful these concepts could possibly be and if they’ll broaden on the plans already in existence by way of the ACA.
“A number of of those provisions would have nearly no impact as a result of they’re already within the ACA, or they appear similar to ones which are already within the ACA,” KFF Senior Vice President Cynthia Cox instructed ABC Information.
Cox, the director of the Program on the ACA on the unbiased well being coverage analysis group, confused that Trump’s plan, in lots of respects, already exists, together with worth transparency and holding massive insurance coverage corporations accountable.
Talking about his plan, the president stated Thursday that “no person’s ever heard of” this concept to offer cash on to the buyer, however Jain famous that what’s often known as “consumerism” has been round for a very long time.
“One of many massive challenges with consumerism is well being care is a fancy business to navigate, and other people do not usually perceive what it’s that they are shopping for or not shopping for,” Jain instructed ABC Information.
Sufferers may also have a “diploma of tension” as a result of they do not at all times know what invoice they’ll get, in response to Jain.
“In relation to true consumerism, looking for well being care is not like looking for different items and providers, principally as a result of folks do not really wish to devour extra well being care,” he stated.
Cox confused that not solely is giving cash on to Individuals not a brand new proposal, it was already in a number of Republican proposals that didn’t advance by way of the Senate in December.
Senate Well being Committee Chairman Invoice Cassidy argued on the time of the invoice’s consideration that his legislative package deal would have put “1000’s in sufferers’ pockets” to assist pay for his or her out-of-pocket bills. However the measure failed by a 51-48 vote simply days earlier than the expiration of the improved ACA tax credit.
White Home officers on Thursday stated Congress’ legislative plans have not been capable of “effectuate” Trump’s want to pay folks straight for his or her well being care prices. With out referencing any lawmakers and their current packages particularly, the administration officers instructed reporters on Thursday that the White Home has engaged with many Hill “allies” on the small print of the president’s new plan.
Cox stated she believes the president’s new technique might additionally create issues for weak Individuals, leaving them with no choice for medical health insurance if they do not get it by way of their employer.
“One doable interpretation of this [plan] is that, you recognize, in the event you give money to folks with none requirement that they use that money to buy ACA market protection — or protection that has protections for folks with pre-existing circumstances — you then may see that wholesome folks use taxpayer {dollars} to buy protection that is not compliant with the Reasonably priced Care Act,” Cox instructed ABC Information.
“What that may imply is that the ACA or Obamacare markets change into destabilized, probably to the purpose of collapsing, which would depart individuals who have pre-existing circumstances and who would in any other case depend on that protection with none choices,” she stated.
Pages from the U.S. Reasonably priced Care Act medical health insurance web site healthcare.gov are seen on a pc display screen in New York, Aug. 19, 2025.
Patrick Sison/AP, FILE
“It might successfully put off the pre-existing situation safety provisions of the Reasonably priced Care Act, and at the very least for people who find themselves shopping for their very own medical health insurance, which is over 20 million folks,” Cox added.
What’s subsequent?
Specialists counsel it is too early to inform how quickly the brand new proposal might influence folks’s well being care, particularly with Congress nearly gone by way of Tuesday.
White Home officers stated the president needs Congress to codify his plan, however did not specify how a lot enter congressional leaders had on the brand new proposal.
The Home final week passed a Democratic-led bill that may see the improved premium tax credit prolonged by three years.
However a path ahead that sends the laws by way of the Senate to the Resolute Desk for Trump’s signature stays in query.
GOP Senate Majority Chief John Thune has stated that there is “no urge for food” for an extension within the higher chamber however pointed to ongoing bipartisan talks on the extensions between senators and Home members.
Since Trump’s video announcement, Home Speaker Mike Johnson has vowed to proceed deliberative discussions with the White Home to decrease well being care prices for Individuals.
In reference to the president’s healthcare plan, Cassidy stated his Senate committee will “take motion” on Trump’s affordability agenda. Republican Sen. Roger Marshall additionally lobbied to work with the president on a complete package deal that features his invoice to make well being care extra inexpensive.
Nonetheless, Democratic Sen. Patty Murray blasted the plan in a publish on X, writing that it took the president over a decade to provide you with a well being care plan that’s “one whole web page.”
“It should do completely NOTHING to cease your premiums from greater than doubling,” she stated.
In the meantime, the president’s plan got here on the final day to enroll in ACA medical health insurance plans in most states, with a couple of exceptions. In line with authorities knowledge, about 1.4 million fewer people have signed up thus far this yr, as premiums skyrocketed after ACA tax credit expired on the finish of 2025.
Cox, at KFF, emphasised that many individuals might face dire penalties with the well being care protection at the moment accessible to them.
“Persons are actually, in some instances, dealing with life or loss of life selections as a result of they can not afford to pay one other $10,000 to maintain their insurance coverage protection, which could imply they go uninsured,” she stated.
ABC Information’ Allison Pecorin and Mary Kekatos contributed to this report.
