Overview
- The White House framework shifts federal subsidies from insurers to individuals via consumer accounts to purchase coverage or care.
- The plan seeks to codify international reference pricing for drugs and expand access to certain over-the-counter medicines.
- Full federal funding of cost-sharing reductions is proposed to lower silver-tier premiums, though analysts warn it could raise net costs for some in bronze and gold plans.
- New transparency rules would require insurers, pharmacy benefit managers, providers and plans taking Medicare or Medicaid funds to disclose margins, benefit spending, denial rates, wait times and price comparisons.
- No congressional sponsor has been identified, and separate Senate talks led by Republican Bernie Moreno focus on a bipartisan, two-year extension of ACA premium subsidies with new eligibility limits.