While Obamacare is in limbo, this week, President Donald Trump announced his new “Great Healthcare Plan,” which promises to help Americans afford medical insurance and care more easily. Lower prescription rates, more transparency from doctors and hospitals, and money in your pocket to purchase your own plans all sound fantastic. The details on how all this works, however, are not so clear.
Healthcare costs are a top concern for most Americans. According to a December poll from the medical policy organization KFF, just under half of US adults say it is difficult to afford health care. About one-third, or 36%, of adults say that in the past 12 months, they have skipped or postponed getting the care they needed because of the prices. Three in four (75%) of uninsured adults under 65 say they went without needed care.
When it comes to prescriptions, about one in five adults (21%) say they haven’t filled their prescriptions because of the cost and 23% say they chose over-the-counter alternatives instead. Approximately one in seven adults claims they have either cut their doses in half or even skipped some because of hefty price tags.
But this doesn’t just affect the uninsured. According to the KFF survey, nearly four in ten insured adults under the age of 68 worry about affording their insurance premiums, “and large shares of adults with employer-sponsored insurance (ESI) and those with Marketplace coverage rate their insurance as ‘fair’ or ‘poor’ when it comes to their monthly premium and out-of-pocket costs to see a doctor.”
The Great Healthcare Plan
With the uncertainty of Obamacare, many people are concerned about their healthcare plans. The president, who is not a fan, said: “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.”
On Thursday, January 15, Trump revealed his “great healthcare plan,” saying: “I am thrilled to announce my plan to lower healthcare prices for all Americans and truly make healthcare affordable again—we’re doing things that nobody’s ever been able to do, we’re calling it The Great Healthcare Plan.”
Here are some of the main points of the plan:
Insurance Premiums
The president promises that this new plan would reduce insurance premiums by ending “the giant kickbacks to insurance brokers and corporate middleman that only drive up the costs…” He added: “It fully funds a long-neglected part of the law known as the Cost Sharing Reduction program. This measure alone should cut premiums on the most popular Obamacare plans—it’s hard to believe there are any because it’s a hated program, it’s unaffordable—but it’s going to cut them by an average of 10 to 15%.”
Furthermore, Trump said people will be getting money to choose their own providers and pay for their medical needs. How this works, exactly, hasn’t yet been explained, but the concept of having the freedom and financial ability to do so is enticing. However, there is no guidance on who will qualify or how much will be paid out to those who do.
Prescriptions
Prescription costs have been an ongoing battle on both sides of the aisle. Former President Joe Biden, in his Inflation Reduction Act of 2022, had some costs capped for Medicaid patients. Trump’s healthcare plan proposes to do more. The commander-in-chief noted that Americans are paying the highest drug prices in the world, but that will all change with this new plan. “It’ll bring down drug prices 80, 90% in some cases, just numbers that nobody’s ever heard of before,” he promised in the press release.
The president’s “most-favored-nation” pricing is supposed to reduce the costs of prescriptions to the lowest compared to other high-income countries. So far, more than a dozen pharmaceutical companies have agreed to lower drug prices for Medicaid patients in exchange for tariff exemptions, Forbes explained. Companies have also agreed to sell some prescription drugs at a discounted rate on Trumprx.gov, the president’s direct-to-consumer platform debuting this month.
While the website doesn’t offer medications, it promises to connect patients with the best prices. “Your prescription drugs will come way, way down and, under this policy, the prices of many drugs will be slashed by 300, 400 even 500% starting this month at the Trumprx.gov,” Trump wrote. The plan also proposes to move more medications from prescription to over-the-counter availability.
Transparency and Accountability
The Great Healthcare Plan also introduces what’s called a “Plain English Insurance Standard” that will require insurers to publish the rates and coverage comparisons in language that is easy to understand, including a breakdown of the percentage of revenues going to claims versus company overhead and profit, as well as denial rates and average routine care wait times, as detailed by Medical Economics. The plan will also require healthcare providers and insurers of Medicare or Medicaid to prominently post their prices at the place of business so that patients aren’t surprised when the bill comes around.
Critics’ Concerns
Details of the plan remain vague. It is not clear how Americans who qualify will get the money to choose their insurance premiums or how much will be received. Furthermore, who will qualify? Trump and other officials in the know have not explained whether existing conditions will be covered with the new medical initiative.
Currently, The Great Healthcare Plan does not replace The Affordable Care Act, but, as Medical Economics noted, “it fundamentally restructures how federal support is delivered — shifting subsidies away from insurers toward direct payments to individuals.”
Congress still has not approved the plan – and gaining that approval may be difficult considering the many questions left unanswered. More than likely, this announcement resembles a preliminary release of what Americans can expect with the details on how it will be achieved to follow later.
