White House Reveals Health Care Plan

On Jan. 15, the White House rolled out a health care plan as a broad framework to help Congress craft legislation to address health care cost challenges.

The plan aims to lower prescription drug prices, reduce insurance premiums and redirect federal subsidies directly to Americans.

“We’re calling it the Great Health Care Plan. Instead of putting the needs of big corporations and special interests first, our plan finally puts you first and puts more money in your pocket.”

- President Donald Trump

White House officials stressed that the plan focuses on reducing costs throughout the health care system, making this broader than just the Affordable Care Act (ACA). According to the White House, the following are the health care plan’s key components:

• Slash prescription drug prices by tying U.S. prices to those paid in comparable countries.
• Allow more over-the-counter medicines by allowing more verified, safe medications to be sold without prescriptions.
• Send federal subsidy money directly to Americans to purchase the health insurance of their choice. This would redirect subsidies paid to insurance companies under the ACA and send them directly to individuals, potentially through health savings accounts.
• Fund a cost-sharing reduction program intended to save taxpayers at least $36 billion and reduce common ACA premiums by over 10%.
• Cut pharmacy benefit manager (PBM) kickbacks that raise insurance costs through middleman brokerage practices.
• Create the “plain-English insurance” standard that would require insurers to publish coverage and rate information—without industry jargon—on their websites.
• Require health insurance companies to publish costs of overhead versus claim payments on their websites.
• Require insurers to display claim denial rates and average wait times for routine care on their websites.
• Require all Medicare- and Medicaid-participating providers and insurers to publicly post their prices to maximize transparency and avoid surprise medical bills.

This plan announcement came as Congress’ effort to reinstate enhanced ACA premium tax credits faces headwinds from the Senate. As such, the future of the lapsed tax credits remains uncertain.

What’s Next?

With premiums rising in employer plans, Medicare and the ACA Marketplace, millions of Americans are facing higher health coverage costs this year.

President Donald Trump urged Congress to act quickly; however, the current framework offers few concrete implementation details, leaving rulemaking and legislative paths uncertain. While some of the proposals may have bipartisan support, such as cracking down on PBMs, many will face opposition in Congress, particularly because they would not extend the lapsed enhanced ACA premium subsidies.

We’ll keep you updated with any notable developments. Contact us for additional resources.