President
Donald
Trump
released
a
plan
on
Thursday
to
lower
drug
costs
and
insurance
premiums,
though
some
healthcare
leaders
say
it
remains
unclear
how
it
would
achieve
those
goals.
The
plan,
titled
the
Great
Healthcare
Plan,
calls
for
codifying
the
Most-Favored-Nation
deals,
which
aim
to
bring
American
drug
prices
in
line
with
similar
nations.
Trump
also
proposed
to
stop
“sending
big
insurance
companies
billions
in
extra
taxpayer-funded
subsidy
payments”
and
instead
send
the
money
directly
to
eligible
Americans
through
their
health
savings
account
so
they
can
purchase
their
own
health
insurance,
according
to
a
fact
sheet.
The
plan
would
fund
a
cost-sharing
reduction
program
for
health
plans
and
end
kickbacks
from
pharmacy
benefit
managers
to
brokerage
middlemen
as
well.
In
addition,
health
insurers
would
be
required
to
publish
rate
and
coverage
comparisons
on
their
websites
in
“plain
English”
and
not
jargon
to
make
it
easier
for
consumers
to
make
coverage
decisions.
The
Great
Healthcare
Plan
would
also
require
health
insurers
to
publicly
disclose
how
much
of
their
revenue
goes
to
claims
versus
overhead
and
profits,
as
well
as
their
claims
denial
rates
and
average
wait
times
for
routine
care.
“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,”
Trump
said.
The
plan
comes
as
Congress
is
torn
over
the
extension
of
the
Affordable
Care
Act
enhanced
premium
tax
credits,
which
lowered
premiums
for
those
purchasing
healthcare
on
the
marketplace
and
expired
at
the
end
of
2025.
According
to
at
least
one
healthcare
executive,
the
plan
lacks
substantial
details.
“Everyone
wants
to
see
drug
prices
and
premiums
come
down,”
said
Ari
Hoffman,
SVP
and
chief
clinical
officer
at
Collective
Health.
“The
challenge
is
how
you
get
there,
and
the
plan
released
by
the
White
House
has
almost
no
details
on
how.
Of
what
policy
content
is
present
in
the
plan,
addressing
PBM
kickbacks,
enhancing
transparency,
and
avoiding
jargon
are
welcome
changes.
But
without
a
clear
and
certain
plan,
I
don’t
see
this
bringing
down
the
rise
in
insurance
premiums.
Insurance
pricing
is
too
sensitive
to
uncertainty,
and
when
policies
change
in
ways
the
market
can’t
predict,
that
risk
ends
up
getting
baked
into
premiums.”
Collective
Health
is
a
health
benefits
platform
for
self-funded
employers.
An
executive
at
KFF,
a
nonprofit
health
policy
organization,
echoed
the
need
for
more
details.
“We
have
been
trying
to
analyze
the
Trump
health
‘plan’
but
I
worry
that
unless
Congress
puts
something
real
together
we
are
analyzing
air.
Big
Q’s
such
as
are
[pre-existing
conditions]
protected
are
impossible
to
answer
from
their
Fact
Sheet.
What
we
do
know:
it
partly
captured
a
news
cycle,”
said
Dr.
Drew
Altman,
KFF’s
president
and
CEO.
Another
healthcare
executive
—
Ahmed
Elsayyad,
president
at
Ostro
—
said
the
plan
could
make
some
improvements,
but
likely
nothing
significant.
Ostro
is
an
agentic
AI
company
for
life
sciences.
“In
the
best
case,
it
increases
price
sensitivity
in
the
parts
of
healthcare
that
are
actually
shop-able
and
creates
some
premium
relief
via
[cost-sharing
reduction]
mechanics,”
he
said.
“In
the
typical
case,
the
impact
is
likely
to
be
uneven
because
much
of
healthcare
spending
is
urgent,
complex,
and
locally
concentrated,
which
limits
consumer
shopping.
…
Net:
potential
marginal
improvements,
but
unlikely
to
be
a
structural
cost
reset
without
detailed
funding,
enforcement,
and
guardrails
for
lower-income
and
high-risk
patients.”
AHIP,
meanwhile,
appears
open
to
the
plan.
“Health
plans
welcome
ideas
to
bring
down
the
unaffordable
prices
drugmakers
charge
Americans
and
to
empower
consumers
to
make
the
best
health
care
decisions
for
themselves
and
their
families,”
said
Chris
Bond,
AHIP
spokesperson.
Photo:
Philip
Rozenski,
Getty
Images