Overview
- The White House framework would redirect federal subsidies to consumers through direct payments or health savings accounts, though eligibility rules and payment amounts are not specified.
- Trump seeks to codify recent ‘Most Favored Nation’ agreements with drugmakers and promote discounted cash purchases via TrumpRx, but experts say savings for most patients are uncertain.
- The proposal calls for insurers and providers to publish prices, medical-loss ratios, claim denial rates and wait-time metrics, and for curbing practices by pharmacy benefit managers and brokers.
- With enhanced ACA premium tax credits expired, preliminary CMS data show 2026 marketplace sign-ups at 22.8 million, about 1.4 million fewer than last year as premiums rise.
- Analysts warn that modest direct payments would not replace ACA subsidies and could pull healthier people out of ACA plans, and the framework does not clearly address protections for pre-existing conditions.