On the final day to enroll in Reasonably priced Care Act (ACA) medical 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 regulation by President Barack Obama. “The Nice Healthcare Plan” presents a proposal to shift authorities insurance coverage subsidies on to shoppers by way of well being financial savings accounts and make the most of his “most favored nation” drug worth initiative.
“My plan would scale back your insurance coverage premiums by stopping authorities payoffs to huge insurance coverage firms and sending that cash on to the folks,” Trump mentioned in a video asserting the plan.
Nevertheless, the video and one-page reality sheet posted on the White Home web site have been gentle 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 Providers through the Obama administration, acknowledged that it is a “fairly huge 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” by way of what modifications may very well be applied.
Except for decreasing drug costs by way of most-favored nation offers and reducing again on insurance coverage subsidies, the plan proposes a cost-sharing provision that the Congressional Funds Workplace estimates would scale back most Obamacare premiums by 10%.
The plan additionally proposes to carry insurance coverage firms accountable with a “Plain English” commonplace and institute pricing necessities for suppliers who settle for Medicare and Medicaid to “prominently submit their pricing and charges.”
Trump urged Congress to “go this framework into regulation at once.”
Some provisions can have ‘nearly no impact’
Some well being coverage specialists imagine with only a one-page reality sheet that there is no strategy to inform how impactful these concepts may very well 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 give the impression of being similar to ones which might be already within the ACA,” KFF Senior Vice President Cynthia Cox instructed ABC Information.
Cox, the director of the Program on the ACA on the impartial well being coverage analysis group, harassed that Trump’s plan, in lots of respects, already exists, together with worth transparency and holding huge insurance coverage firms accountable.
Talking about his plan, the president mentioned Thursday that “no one’s ever heard of” this concept to provide cash on to the patron, however Jain famous that what’s often called “consumerism” has been round for a very long time.
“One of many huge challenges with consumerism is well being care is a fancy trade 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 additionally have a “diploma of tension” as a result of they do not at all times know what invoice they will get, in response to Jain.
“In terms of true consumerism, looking for well being care is not like looking for different items and providers, largely as a result of folks do not really wish to devour extra well being care,” he mentioned.
Cox harassed 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 bundle 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 want to pay folks immediately for his or her well being care prices. With out referencing any lawmakers and their present packages particularly, the administration officers instructed 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 Individuals, leaving them with no possibility for medical insurance if they do not get it by way of their employer.
“One potential interpretation of this [plan] is that, , 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 — then you definitely 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 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 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 dispose of 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 insurance, which is over 20 million folks,” Cox added.
What’s subsequent?
Specialists recommend it is too early to inform how quickly the brand new proposal might affect folks’s well being care, particularly with Congress nearly gone by way of Tuesday.
White Home officers mentioned 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 handed a Democratic-led invoice 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 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 Individuals.
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 bundle that features his invoice to make well being care extra inexpensive.
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 can 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 insurance plans in most states, with just a few exceptions. In response to authorities knowledge, about 1.4 million fewer folks have signed up to this point this 12 months, 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 present obtainable to them.
“Individuals are actually, in some instances, going through life or dying 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 mentioned.
ABC Information’ Allison Pecorin and Mary Kekatos contributed to this report.
