Trump Announces, “The Great Healthcare Plan”, But Will It Get Through Congress?
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Article Summary
President Trump announced the proposed “Great Healthcare Plan” in January 2026, outlining a framework to lower prescription drug costs and insurance premiums. The plan includes efforts to codify Most-Favored-Nation drug pricing, shift insurance subsidies toward direct support for eligible individuals, and increase transparency and accountability for insurance carriers and providers. Because the proposal requires Congressional approval and key implementation details remain unclear, its potential impact on employers and plan sponsors is uncertain. OneDigital will continue monitoring developments as the legislative process unfolds.
With the hopes of lowering drug prices and insurance premiums, President Trump announced the “Great Healthcare Plan” (Plan) on January 15, 2026. The Plan is a framework and must be passed by Congress and signed by the president before becoming law.
Prescription Drugs
The Plan proposes legislative action to codify the administration’s “Most-Favored-Nation” prescription drug agreements. This would allow for expanded access to lower-cost medications and increase the availability of certain pharmaceutical drugs available to purchase over-the-counter.
Health Premiums
The Plan outlines a shift way from taxpayer-funded subsidy payments. Instead, funds would be directed to eligible individuals to apply toward the health insurance plan of their choice. Details such as the definition of “eligible Americans,” payment amounts, income thresholds, and delivery mechanisms are not specified. The Plan also includes provisions intended to eliminate what it defines as kickbacks practices involving pharmacy benefit managers and intermediary brokers.
Increased Accountability for Insurance Carriers
The Plan includes requirements designed to increase transparency within the health insurance industry. Key components include:
- Plain-language disclosures: Insurance carriers would be required to provide clear, jargon-free notices and revenue reporting.
- Transparency: Carriers would need to publish data showing the percentage of their revenues that are paid out to claims versus overhead costs, percentage of claims they reject, and average wait times for routine care on their website.
- Provider Pricing visibility: Any healthcare provider or insurer that accepts Medicare or Medicaid would be required to make pricing and fees prominently accessible.
At this stage, it is unclear how these proposed requirements would differ existing federal transparency rules, which already require public data on claim denials, insurer administrative costs, and the use of “Plan English” insurance summaries. Additionally, during Trump’s first administration, federal agencies issued price-transparency regulations that required insurers and group health plans to publicly disclose negotiated rates, out of network payment amounts, prescription drug pricing information, and to maintain consumer facing online tools for accessing price information.
More recently, a 2025 Executive Order directed federal departments to further implement and enforce these earlier transparency regulations, including ensuring publication of actual prices and strengthening compliance efforts among hospitals and insurers.
As noted above, the Plan requires Congressional approval and presidential signature before becoming law. Until further details are released, the potential impact on plan sponsors and participants remains uncertain, and the likelihood of Congressional action is also unknown OneDigital will continue monitoring all healthcare legislation and providing regular updates.