Trump unveils health care affordability plan

President Trump on Thursday unveiled an affordability framework for health care aimed at lowering drug prices and insurance premiums, as he seeks to address a major Republican political liability ahead of the midterm elections.

Affordability is a key issue for voters, and the health plan is part of the administration’s efforts to reassure the public that everyday costs are going down.  

“I’m calling on Congress to pass this framework into law without delay,” Trump said in a video message. “Have to do it right now so that we can get immediate relief to the American people.”  

The announcement came as a lawmakers have been unable to come to an agreement on enhanced Affordable Care Act (ACA) tax credits that expired at the end of last year, resulting in a major spike in out-of-pocket premium costs for tens of millions of people. 

Democrats have relentlessly attacked Republicans for failing to extend the tax credits. Trump’s plan is a response and tacit acknowledgement that the GOP could get blamed for high health care prices. 

The framework, which Trump dubbed “The Great Healthcare Plan,” includes many proposals that Trump or Congress have pushed in recent years, but it does not call for a subsidy extension. 

Trump said Congress needs to codify the White House’s voluntary “most favored nation” agreements with drug companies to lower prices of certain prescriptions and increase the availability of over-the-counter medicines.  

The plan also builds on Trump’s calls to send billions in subsidies directly to Americans rather than insurance companies, which he has been advocating for amid the debate over whether to extend the ACA’s expired enhanced premium subsidies.

Trump’s framework would allow individuals to use government subsidies to purchase health insurance plans of their choice. It didn’t specify if the plans would need to meet ACA rules, including covering preexisting conditions. 

It would fund the health law’s cost-sharing reductions for health plans, which would save the government tens of billions of dollars by reducing the federal subsidies that help people afford premiums.  

Trump’s plan also targets the prescription drug intermediaries known as pharmacy benefit managers, or PBMs. The White House said the plan “will end the kickbacks” paid by PBMs “to the large brokerage middlemen that deceptively raise the cost of health insurance.” 

On health insurance, the administration wants more transparency from the industry on medical claim denials, wait times and prices, as well as simpler language to help people better understand their options. 

The plan also would require insurance companies to publish on their websites the percentage of revenues paid for claims versus overhead costs and profits, the percentage of claims they reject and the average wait times for routine care. 

The White House in a fact sheet called the plan “comprehensive,” though it was delivered as a broad outline without key details on how to implement it or pay for it. 

The plan comes as Republicans in Congress have floated a second party-line megabill that could be passed through the reconciliation process without Democratic support. But it’s not yet clear if the White House framework would be part of that plan.