Overview
- The White House released a one-page framework that would redirect federal assistance from ACA premium tax credits to direct payments for consumers, likely via health savings accounts, which would require congressional approval.
- The plan seeks to codify a ‘most-favored-nation’ approach tying U.S. drug prices to the lowest prices in peer countries, expand over‑the‑counter access to certain drugs, and tighten transparency requirements for insurers and providers.
- It proposes funding ACA cost-sharing reductions, with the White House citing CBO estimates of at least $36 billion in taxpayer savings and more than a 10% cut to common exchange premiums, though analysts say effects could vary by metal tier.
- Senate negotiators led by Sen. Bernie Moreno say a bipartisan extension of the expired ACA subsidies is likely weeks away, the House passed a three-year extension on Jan. 8, and President Trump has suggested he might veto a straightforward renewal.
- CMS data show roughly 1.5 million fewer exchange enrollees after the enhanced credits expired Dec. 31, and surveyed experts warn shifting subsidies into HSAs could worsen affordability for many consumers.