President Trump’s Great Healthcare Plan: Here’s what to know now

President Donald J. Trump unveiled the Great Healthcare Plan with reform proposals aimed at drug prices, insurance and price transparency.

While the announced proposal does not mention primary care specifically, there are at least three targets: Big Pharma, insurance companies and pharmacy benefit managers. The goal: Lower prices for American patients.

“We will have maximum price transparency and costs will come down incredibly,” the president said. “I’m calling on Congress to pass this framework into law without delay — we have to do it right now so that we can get immediate relief to the American people, the people I love.”

This explainer was compiled from the White House announcement, the website dedicated to the plan, an accompanying fact sheet, and online news sources.

What is the Great Healthcare Plan?

The Great Healthcare Plan is a federal healthcare proposal introduced by President Donald J. Trump in January 2026. It is presented as a comprehensive strategy to lower prescription drug prices, reduce insurance premiums, increase price transparency, and change the way government healthcare funds are distributed to individuals instead of insurers.

What are the core goals of this plan?

The plan’s primary stated goals are to:

• Slash prescription drug prices by codifying new pricing deals.
• Lower insurance premiums for consumers.
• Hold big insurance companies “accountable” with clearer data and standards.
• Maximize price transparency across healthcare services and insurers.
• Direct federal healthcare funds to individuals rather than to insurance companies.

How does the plan propose reducing prescription drug prices?

The proposal would codify the administration’s Most-Favored-Nation pricing agreements, designed to align U.S. drug costs with the lowest prices paid in other developed nations. It also aims to expand access to verified safe drugs as over-the-counter (OTC) medicine, potentially increasing competition and lowering overall costs.

What does “sending money directly to the American people” mean under this plan?

Instead of sending taxpayer-funded subsidies to insurance companies (as occurs under the Affordable Care Act), the plan would redirect those funds to eligible individuals. The intent is for individuals to use these direct payments to buy health insurance of their choice or cover medical expenses, potentially through health savings accounts (HSAs) or similar mechanisms.

How would insurance premiums be lowered?

According to the plan’s fact sheet:

• The federal government would end extra taxpayer subsidies to insurers and instead fund a cost-sharing reduction program, which the Congressional Budget Office estimates could lower standard plan premiums by more than 10%.
• It would also eliminate pharmacy benefit manager (PBM) kickbacks that the administration says artificially raise insurance costs.

What does the plan do to hold insurance companies “accountable”?

The Great Healthcare Plan introduces a “Plain English Insurance Standard” requiring insurers to clearly publish:

• Rate and coverage comparisons in easy-to-understand terms.
• Breakdown of the percentage of revenue going to claims versus overhead and profit.
• Claims denial rates and average routine care wait times.
  These are intended to help consumers make more informed coverage decisions.

What are the price transparency measures in the proposal?

The plan mandates that any health care provider or insurer accepting Medicare or Medicaid must prominently post their prices and fees at their place of business. This seeks to reduce surprise billing and enable patients to shop more effectively for services.

Does the plan replace the Affordable Care Act (ACA)?

The proposal does not repeal the ACA outright, but it fundamentally restructures how federal support is delivered — shifting away from subsidies going to insurers toward direct payments to individuals. It also proposes significant changes to premium subsidies and cost-sharing mechanisms. Observers note that it is a framework requiring Congressional approval, and does not itself fully replace existing law without further legislation.

Does the president now support ACA, also known as Obamacare?

No. The president used his announcement to dig at the health plan advocated by his predecessor: “Obamacare was designed to make insurance companies rich. I call it the UNAFFORDABLE Care Act, with billions of dollars and taxpayer subsidies that help their stock prices skyrocket over 1,700% as you paid more money for healthcare every single year — more and more the premiums went higher and higher.”

How might this affect patients with pre-existing conditions?

The official proposal materials do not explicitly expand or detail protections for pre-existing conditions in the same way the ACA currently does. Critics have raised concerns that without robust guaranteed coverage standards, patients with significant medical needs may face higher costs or coverage barriers.

What are potential criticisms or concerns from healthcare stakeholders?

Analysts and stakeholders have raised several concerns:

• That direct payments to individuals may not adequately replace ACA subsidies, especially for lower-income patients.
• That moving more drugs OTC could shift costs to patients and reduce insurance coverage for essential medications.
• That the plan lacks detailed implementation mechanisms and relies on Congress to act.
• Implementation challenges could affect stability in insurance markets during transition.

What is the legislative status of the plan?

As of its unveiling in January 2026, the plan is a legislative proposal that requires action by Congress to become law. The administration is urging rapid passage, but details about timing and specific legislative vehicles are pending further congressional negotiation.

What should independent physicians understand about its impact on practice economics?

Key practice-level implications may include:

• Changes in how patients fund care, especially via HSAs or direct subsidy payments.
• Potential shifts in insurance plan offerings and payer mixes if premiums and plan structures change.
• Greater price transparency could affect patient expectations and negotiation dynamics.
• Drug price reductions might change prescribing behaviors and medication cost burdens.