Overview
- The blueprint bundles conservative ideas including international drug price benchmarking, expanded over‑the‑counter access, restoration of ACA cost‑sharing payments, PBM payment changes, and new insurer and provider transparency rules.
- A headline proposal would redirect some subsidy dollars from insurers to individuals, likely via health savings accounts, though the mechanics and eligibility are not specified.
- CRFB estimates the cost‑cutting pieces could reduce primary deficits by roughly $50 billion over a decade, while the subsidy redesign could range from modest savings to up to $350 billion in added costs depending on design.
- A related Republican bill scored by CBO was projected to save about $35.6 billion over 10 years, lower premiums by roughly 11% through 2035, and reduce coverage by an average of 100,000 people.
- Legal and political obstacles loom, including prior court challenges to Trump‑era international reference pricing, and Congress is currently focused on extending ACA premium subsidies rather than advancing the new framework.