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White House Unveils 'Great Healthcare Plan' Steering Subsidies to Consumers

The one-page framework omits any extension of lapsed ACA subsidies, leaving specifics for lawmakers to define.

Overview

  • The administration released a brief fact sheet and video with no legislative text or timeline and did not propose renewing the expired enhanced ACA premium tax credits.
  • The framework rejects routing extra federal payments through insurers and instead proposes sending money directly to eligible Americans, likely via health savings account–style deposits.
  • Other elements include codifying "most favored nation" drug-pricing deals, expanding over-the-counter access to some medicines, new transparency requirements, and restoring ACA cost-sharing reductions that CBO says could cut certain silver-plan premiums by about 10% and save roughly $36 billion.
  • Health policy experts said the scant details create uncertainty and warned that cash-like subsidies could shift healthy consumers into non‑ACA plans, risking marketplace destabilization and leaving protections for preexisting conditions unclear.
  • Industry reaction split, with PhRMA criticizing international reference pricing as harmful to innovation and some insurers welcoming parts of the agenda, while bipartisan Senate talks on a narrower, temporary subsidy extension remain stalled.