On January 15, 2026, President Donald Trump announced a new healthcare initiative known as the 'Great Healthcare Plan.' This proposal seeks to lower prescription drug prices, reduce health insurance premiums, and enhance accountability for insurance companies, while also improving price transparency in the healthcare sector. Trump emphasized that the plan prioritizes individual needs over corporate interests, asserting that financial assistance would be directed to consumers rather than insurers.

The proposal coincides with ongoing discussions in Congress regarding the extension of enhanced tax credits under the Affordable Care Act (ACA), which expired at the end of 2025, leading to increased premiums for many Americans. The Congressional Budget Office estimates that extending these tax credits could significantly increase the number of insured individuals, potentially adding millions to the rolls in the coming years.

Key features of the Great Healthcare Plan include the implementation of 'Most Favored Nation' pricing for prescription drugs, which aims to align U.S. drug prices with those in other affluent countries, and the expansion of over-the-counter access to verified pharmaceutical drugs. Additionally, the plan proposes redirecting taxpayer-funded subsidies from health insurers to individuals, which could reduce health insurance premiums by at least 10 percent and save taxpayers approximately $36 billion.

However, the proposal has faced criticism for its lack of detail and potential negative implications for consumers. Advocacy group Protect Our Care labeled it a 'joke healthcare plan,' arguing that it fails to adequately address the needs of the American public and could lead to higher costs and reduced care. Critics highlighted that significant cuts to Medicaid under the Trump administration have disproportionately affected working families, while health premiums have risen dramatically.

Cynthia Cox, director of the program on the ACA at the Kaiser Family Foundation, noted that the proposal lacks essential specifics, stating, 'When it comes to health reform, the devil is in the details, and this is very light on details.' Furthermore, Art Caplan, head of the medical ethics division at NYU Grossman School of Medicine, criticized the plan for placing an unrealistic burden on consumers to navigate a complex healthcare system, particularly for those facing urgent medical needs.

The administration has indicated that the implementation of direct payments and other proposals would require Congressional action, leading to uncertainty regarding their feasibility and timeline. Trump has previously suggested that federal funds could be sent directly to patients to help mitigate rising premiums under the ACA, but specifics on how this would be executed remain unclear.

As Congress continues to negotiate the future of healthcare subsidies, the administration's proposal has raised concerns about the potential destabilization of ACA marketplaces, particularly for individuals with pre-existing conditions. The House has passed a bill to extend enhanced ACA tax credits for three additional years, but the Senate is still deliberating its own version, with Trump suggesting he may veto such an extension. Critics argue that a viable solution to the ongoing healthcare affordability crisis would be to support the extension of these tax credits, which have bipartisan backing.