On January 15, 2026, the White House released an outline of its proposed healthcare agenda, “The Great Healthcare Plan.” The proposal was issued in response to months of deliberations surrounding the future of enhanced premium tax credits under the Affordable Care Act, as well as scheduled reforms for Medicaid.
While the announcement did not provide significant details, it did outline the administration’s main healthcare objectives, which included lowering prescription drug prices and reducing health insurance premiums. The proposal also called on Congress to enact a comprehensive health plan that would “hold big insurance companies accountable” and “maximize price transparency.”
Among the specific proposals was a plan to codify the administration’s “most-favored-nation” deals with prescription drug companies, which sought to provide access to the same lower drug prices offered in other countries. The White House stated that this would build off previous attempts by the administration to make insulin more affordable, as well as successful voluntary negotiations following a recent Executive Order to lower drug prices. (Please see our prior article on the order to lower drug prices.) The plan also proposed increasing the number of verified safe pharmaceutical drugs available for over-the-counter purchase. Another plan objective would be putting an end to “kickbacks” paid by pharmacy benefit managers to “large brokerage middlemen.”
Furthermore, the plan would fund a new cost-sharing reduction program that would reduce ACA marketplace premiums while saving taxpayers $36 billion. In addition, the plan would send money directly to individuals to purchase plans of their choice, although no specific details were provided regarding the method in which consumers would receive the funds. The plan would also require health insurers to publish rate and coverage comparisons in a clearer format on the website, as well as the percentage of revenue paid out to claims versus overhead costs and profits. Health insurers would further be required to publish claim denial rates and the average wait times for routine care.
Employer Takeaway
While the lack of details in “The Great Healthcare Plan” makes it difficult to determine the scope and impact of its proposals, this is the first major announcement by the administration regarding its healthcare agenda and policy objectives. Much of the plan is contingent on congressional action, and the legislative deadlock surrounding the extension of ACA marketplace subsidies would suggest such action would be difficult. However, employers should continue to monitor developments regarding the plan, and progress by lawmakers to pass a bipartisan healthcare solution that would align with the administration’s priorities.
Refer to the White House announcement and fact sheet for an outline of the proposal.