Here’s what President Trump is planning.
President Donald Trump is putting health insurance companies at the center of a new push to change how Americans pay for healthcare, promising to redirect certain federal subsidies, increase price transparency and give consumers more information about where their insurance dollars are going.
During his speech at the Republican midterm convention in Dallas, Trump renewed his call for Congress to pass what his administration calls the Great Healthcare Plan.
The proposal targets several issues affecting household budgets, including health insurance premiums, prescription drug prices, medical bills and healthcare price transparency.
One of its biggest proposed changes would alter how certain federal healthcare subsidies reach consumers.
Instead of sending the money to insurance companies, Trump wants eligible Americans to receive the funds directly and use them to purchase health coverage.
“We will pass the Great Healthcare plan to stop all government payments to big insurance companies, and give the money directly to the people, for you to buy your own healthcare and have money left over,” Trump said during his Dallas address.
The proposal could have significant implications for Americans who purchase private health insurance, including people approaching retirement who are not yet eligible for Medicare.
But many provisions would require congressional approval before becoming law.
Trump Wants Healthcare Money Sent Directly To Consumers
At the heart of Trump’s proposal is an effort to change the relationship between the federal government, insurance companies and consumers.
The White House says the Great Healthcare Plan would stop certain additional taxpayer-funded subsidy payments from going to major insurance companies. Instead, eligible Americans would receive money that could be used to purchase health insurance.
Trump argues that putting the funds directly in consumers’ hands would give Americans greater control over their healthcare choices.
The details will be critical.
Questions such as who qualifies, how much money consumers would receive and which insurance policies could be purchased would ultimately determine how the proposal affects individual families.
Those details could become a major focus if Congress takes up the legislation.
Health Insurance Companies Could Face Tougher Disclosure Rules
Trump’s proposal doesn’t stop with subsidies.
The Great Healthcare Plan would also require insurance companies to disclose considerably more information to consumers.
Under the administration’s proposed “Plain English Insurance” standard, health insurers would have to publish rate and coverage comparisons in language designed to be easier for consumers to understand.
Insurance companies would also be required to disclose how much of their revenue goes toward paying medical claims compared with overhead expenses and profits.
Perhaps more importantly for patients who have struggled with denied insurance claims, companies would have to disclose the percentage of claims they reject.
Average wait times for routine care would also have to be published.
For consumers comparing health insurance plans, those numbers could provide another way to evaluate insurers beyond monthly premiums and deductibles.
Trump Pushes For Greater Healthcare Price Transparency
Another major piece of the proposal involves the prices Americans pay for medical care.
Trump said he wants patients to know what healthcare services cost rather than discovering the price after treatment.
The Great Healthcare Plan calls for healthcare providers and insurers accepting Medicare or Medicaid to prominently display pricing and fees.
“We will end surprise medical billing, and require insurers and hospitals to post all prices clearly in plain English,” Trump said.
Price transparency has been a recurring healthcare issue because patients can sometimes have difficulty determining the cost of a procedure or medical service before receiving care.
The administration says greater disclosure would make it easier for consumers to compare prices and potentially shop for lower-cost healthcare.
Prescription Drug Prices Are A Major Part Of Trump’s Plan
Prescription medications are another major component of Trump’s healthcare agenda.
The president is calling on Congress to codify his administration’s Most-Favored-Nation prescription drug pricing agreements.
The policy is intended to bring prices for participating medications closer to prices available in other developed countries.
Trump has claimed that some prescription drugs could see extremely large reductions under the approach.
Those claims should not be interpreted as a guarantee that every American or every prescription would receive the same reduction. Actual savings can vary substantially depending on the medication, manufacturer, insurance coverage and other factors.
The administration announced in August that it had reached Most-Favored-Nation agreements with 26 pharmaceutical manufacturers covering a large share of the branded prescription-drug market.
Trump now wants Congress to make key elements of that strategy permanent.
Could Health Insurance Premiums Come Down?
The proposal also addresses Obamacare, formally known as the Affordable Care Act (ACA).
Trump’s plan calls for funding a cost-sharing reduction program for healthcare plans.
The White House says this provision would reduce premiums for commonly purchased Obamacare plans by more than 10%, citing Congressional Budget Office estimates associated with the policy.
The administration also says the provision could produce billions of dollars in taxpayer savings.
However, the ultimate financial impact would depend on the legislation Congress passes and how the changes are implemented.
Middlemen And Insurance Costs Also Face Scrutiny
The Great Healthcare Plan also targets financial arrangements involving pharmacy benefit managers, insurance brokers and other healthcare middlemen.
The administration argues that certain payments and financial incentives involving these companies contribute to higher health insurance costs.
Trump wants those arrangements restricted as part of his broader effort to reduce premiums.
This portion of the proposal could receive significant attention because pharmacy benefit managers play an important role in negotiating prescription drug prices and determining how medications are covered.
What Could This Mean For Americans Over 50?
For Americans in their 50s and early 60s, healthcare costs can become an increasingly important part of household financial planning.
People who retire before reaching Medicare eligibility at age 65 may need to purchase coverage through an employer, the ACA marketplace or the private insurance market.
That makes questions surrounding insurance premiums, deductibles, prescription costs and out-of-pocket medical expenses particularly important.
Americans already enrolled in Medicare may also want to watch the debate closely because Trump’s proposal includes broader healthcare pricing requirements involving providers and insurers that participate in Medicare or Medicaid.
However, consumers should not assume their current coverage or costs will immediately change.
Much of Trump’s plan requires congressional action.
Congress Is The Next Major Hurdle
Trump can promote the Great Healthcare Plan from the White House, but Congress will ultimately determine whether many of its biggest provisions become federal law.
That distinction matters.
Republicans attempted a sweeping healthcare overhaul during Trump’s first administration but were unable to secure enough Senate support to complete the effort.
Trump is now renewing his healthcare push while Republicans campaign to retain their congressional majorities in the November midterm elections.
“We have to have Congress. We have to have the majorities,” Trump told the convention.
Healthcare could therefore become another major issue in the midterm debate, particularly as voters continue to focus on the cost of insurance, prescription medications and everyday medical care.
The Bottom Line
Trump’s Great Healthcare Plan represents an effort to change how federal healthcare money is distributed while imposing additional transparency requirements on insurers and healthcare providers.
Among the most significant proposals are sending certain healthcare subsidies directly to eligible Americans, requiring insurers to disclose claim-denial information, expanding healthcare price transparency, addressing prescription drug costs and changing policies affecting insurance premiums.
Whether those proposals ultimately become law will depend largely on Congress.
For consumers, the most important details will be the ones affecting their wallets: monthly premiums, prescription drug prices, deductibles, medical bills and the amount of financial assistance available to purchase coverage.
Until Congress acts, many of the changes remain proposals rather than guaranteed benefits.
But Trump’s latest remarks make clear that healthcare—and the role played by America’s largest insurance companies—will remain a significant part of his domestic policy agenda.