Overview
- The outline released by the White House is a short framework with no bill text or timeline, and its implementation would require congressional action.
- Core proposals include directing subsidy dollars to consumers, codifying international reference drug pricing, expanding over-the-counter access, funding ACA cost-sharing reductions, altering PBM payments, and increasing price transparency.
- The Committee for a Responsible Federal Budget estimates cost-lowering elements could save about $50 billion over 10 years, while ACA-related subsidy changes could raise deficits by up to $350 billion depending on specifics.
- A related Republican bill analyzed by the Congressional Budget Office was projected to save $35.6 billion over a decade, reduce premiums roughly 11% through 2035, and lower insured counts by an average of about 100,000 people.
- Policy experts and advocates question potential market disruption and legal risks tied to international price benchmarking, and separate from the White House concept the House has passed a three-year extension of enhanced ACA premium tax credits now before the Senate.