The Trump administration announced a plan aimed at lowering health care costs in the U.S. on Thursday, just as Affordable Care Act open enrollment ends in most states. But the plan lacks key details and largely restates proposals President Donald Trump has previously outlined.
The proposal, dubbed “The Great Healthcare Plan,” is being framed by administration officials as a broader effort to rein in health costs, including lowering prescription drug prices, redirecting government subsidies from insurers to consumers and expanding price transparency requirements.
Trump has previously pitched sending federal funds directly to patients to address skyrocketing premiums under the ACA.
”The government is going to pay the money directly to you,” Trump said in a video the White House released. “It goes to you, and then you take the money and buy your own health care.”
Direct payments and other proposals, however, would require action from Congress, raising questions about how quickly — or whether — they could be implemented.
Republicans in Congress have been in negotiations for a bill to extend the enhanced ACA tax credits, which expired Dec. 31 and led to higher premiums for millions of Americans.
During a call with reporters Thursday, administration officials offered no details on how the government would distribute money directly to patients, how large those payments would be or who would qualify.
“We want to start to see that money moved directly to people,” an administration official said. “There are a lot of different ways that could take place. We are open to working with Congress on how to effectuate that.”
Larry Levitt, executive vice president for health policy at KFF, a nonpartisan research group, said the plan could send the ACA marketplace into a “death spiral.”
The tax credits don’t go directly to insurers as extra money. They’re applied to a person’s monthly premium bill each month, lowering the amount they owe.
“President Trump is suggesting here that people could use government subsidies to buy insurance that doesn’t comply with ACA rules, including coverage of pre-existing conditions,” Levitt said.
The administration official said the plan does not “close the door” on ongoing negotiations to extend the enhanced subsidies. This month, the House passed a bill to extend the credits for three more years, and the Senate is drafting its own separate version. Trump, however, has suggested he might veto an extension.
Trump’s preference, the administration official said on the call, is to send the money directly to patients.
On Thursday’s call, Dr. Mehmet Oz, the administrator of the Centers for Medicare & Medicaid Services, also touted Trump’s “most favored nation” drug pricing push, which ties U.S. prices to those paid in other wealthy countries.
Trump first announced that initiative last May, and the administration has so far reached agreements with 14 major drugmakers.
Oz also highlighted TrumpRx, the new self-pay prescription drug platform that is expected to launch later this month.
Experts have questioned how much people would actually save on the platform, since most insured patients already get lower prices through their coverage and the Medicaid program pays some of the lowest rates.
The administration urged Congress to pass legislation “without delay,” saying it would deliver relief from what it called the “Unaffordable Care Act” — a quip often used by Trump to criticize the program’s high costs.