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 consultants 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 shoppers by well being financial savings accounts and reap the benefits of his “most favored nation” drug value initiative.
“My plan would scale back your insurance coverage premiums by stopping authorities payoffs to massive insurance coverage firms and sending that cash on to the individuals,” Trump mentioned in a video asserting the plan.
Nonetheless, the video and one-page truth sheet posted on the White Home web site had been mild on specifics about how a lot would truly go to People or how a lot funding the plan would require or how the funds could be distributed.
Dr. Sachin Jain, a former official within the Division of Well being and Human Companies through the Obama administration, acknowledged that it is a “fairly massive step” for Trump to articulate well being care as a significant 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, advised ABC Information “well being care is certainly one of these areas the place the satan is at all times within the particulars” by way of what modifications may very well be applied.
Apart from reducing drug costs by most-favored nation offers and reducing again on insurance coverage subsidies, the plan proposes a cost-sharing provision that the Congressional Finances Workplace estimates would scale back most Obamacare premiums by 10%.
The plan additionally proposes to carry insurance coverage firms accountable with a “Plain English” normal and institute pricing necessities for suppliers who settle for Medicare and Medicaid to “prominently submit their pricing and charges.”
Trump urged Congress to “cross this framework into legislation directly.”
Some provisions could have ‘just about no impact’
Some well being coverage consultants imagine with only a one-page truth sheet that there is not any approach to inform how impactful these concepts may very well be and if they’ll broaden on the plans already in existence by the ACA.
“A number of of those provisions would have just about no impact as a result of they’re already within the ACA, or they appear similar to ones which might be already within the ACA,” KFF Senior Vice President Cynthia Cox advised ABC Information.
Cox, the director of the Program on the ACA on the unbiased well being coverage analysis group, harassed that Trump’s plan, in lots of respects, already exists, together with value transparency and holding massive insurance coverage firms accountable.
Talking about his plan, the president mentioned Thursday that “no one’s ever heard of” this concept to offer cash on to the buyer, however Jain famous that what’s generally known as “consumerism” has been round for a very long time.
“One of many massive challenges with consumerism is well being care is a posh trade to navigate, and folks do not usually perceive what it’s that they are shopping for or not shopping for,” Jain advised ABC Information.
Sufferers may also have a “diploma of hysteria” as a result of they do not at all times know what invoice they will get, in keeping with Jain.
“With regards to true consumerism, purchasing for well being care is not like purchasing for different items and companies, principally as a result of individuals do not truly wish to devour extra well being care,” he mentioned.
Cox harassed that not solely is giving cash on to People not a brand new proposal, it was already in a number of Republican proposals that didn’t advance by 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 mentioned Congress’ legislative plans have not been capable of “effectuate” Trump’s need to pay individuals immediately for his or her well being care prices. With out referencing any lawmakers and their present packages particularly, the administration officers advised reporters on Thursday that the White Home has engaged with many Hill “allies” on the main points of the president’s new plan.
Cox mentioned she believes the president’s new technique might additionally create issues for susceptible People, leaving them with no choice for medical health insurance if they do not get it by their employer.
“One attainable interpretation of this [plan] is that, you recognize, in case you give money to individuals with none requirement that they use that money to buy ACA market protection — or protection that has protections for individuals with pre-existing circumstances — then you definately may see that wholesome individuals use taxpayer {dollars} to buy protection that is not compliant with the Reasonably priced Care Act,” Cox advised ABC Information.
“What that may imply is that the ACA or Obamacare markets turn out to be destabilized, probably to the purpose of collapsing, which would go away individuals who have pre-existing circumstances and who would in any other case depend on that protection with none choices,” she mentioned.
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 get rid of the pre-existing situation safety provisions of the Reasonably priced Care Act, and a minimum of for people who find themselves shopping for their very own medical health insurance, which is over 20 million individuals,” Cox added.
What’s subsequent?
Specialists counsel it is too early to inform how quickly the brand new proposal might impression individuals’s well being care, particularly with Congress just about gone by Tuesday.
White Home officers mentioned the president desires 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 the Senate to the Resolute Desk for Trump’s signature stays in query.
GOP Senate Majority Chief John Thune has mentioned 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 People.
In reference to the president’s healthcare plan, Cassidy mentioned 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 reasonably priced.
Nonetheless, Democratic Sen. Patty Murray blasted the plan in a submit on X, writing that it took the president over a decade to give you a well being care plan that’s “one total web page.”
“It is going to do completely NOTHING to cease your premiums from greater than doubling,” she mentioned.
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. Based on authorities information, about 1.4 million fewer people have signed up to this point 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 presently obtainable to them.
“Individuals are actually, in some circumstances, going through life or demise choices 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 mentioned.
ABC Information’ Allison Pecorin and Mary Kekatos contributed to this report.
