On January 15, 2026, President Trump rolled out his latest vision for healthcare in a video, known as “The Great Healthcare Plan”. The plan aims to tackle high drug costs and rising insurance premiums, while promising to maximize price transparency.
If properly implemented, the plan has the potential to transform U.S. healthcare that has been largely unaffordable for millions of Americans. Just under half of U.S. adults say it is difficult to afford health care costs, according to a KFF poll. However, as currently articulated by the Trump administration, the “Great Healthcare Plan” has a host of uncertainties that will shape what the ultimate impact of this initiative will be for the American people. Here are some unanswered questions.
Who Qualifies And How Much Money Will Consumers Receive?
Under the plan, the federal government will send money directly to eligible Americans so they can purchase health insurance of their choice. The White House announcement stops short of providing details on any definition of eligibility criteria. Without this definition, it would be difficult to assess whether this approach would improve access to care, particularly for marginalized populations.
In addition, there was no mention of how much money eligible Americans would receive. Even if every American received $3,000, that would not be enough to afford a standard silver plan in the Affordable Care Act marketplace. Although rates vary based on one’s income, age and location, an average monthly premium for a silver plan would be somewhere between $450-$600 without tax subsidies. This would translate to $5,400-$7,200 per year. These rates also do not include deductibles, or the amount one has to spend for healthcare out of pocket before insurance coverage kicks in.
How Will This Affect Those With Pre-Existing Conditions?
A major part of the Affordable Care Act was protection for people with pre-existing conditions. For decades, insurance companies in the United States could prevent Americans from enrolling in insurance plans if they had pre-existing conditions like diabetes or even cancer. Trump’s new plan does not address whether such protections would be maintained, expanded or weakened. Without explicit safeguards, this particular group could face higher premiums or restricted access to necessary care.
What Will The Overall Impact Be Of Lowered Drug Prices?
Trump’s “most-favored-nation” pricing deals would tie U.S. drug costs to the lowest prices in other high-income countries. To date, more than a dozen pharmaceutical companies have agreed to lower drug prices for Medicaid patients in exchange for exemptions from tariffs. However, patients enrolled in Medicaid already pay low drug prices and data has not yet been compiled on exactly how much these patients will actually save or if they will even save any money on the new plan touted by President Trump.
In addition, pharmaceutical companies have agreed to sell several prescription drugs at a discounted price on Trump’s direct-to-consumer platform that will launch this month, Trump Rx. As an example, Wegovy, the blockbuster GLP-1 weight loss drug, will be available in its oral form for $150 a month and $350 per month in injectable form. However, for those with commercial insurance, the same drug can cost as little as $25 per month. Thus, despite the drastic cuts in many drug prices that have been initiated by the Trump administration, it is unclear exactly how much cost savings will occur from the initiatives that are to be implemented.
How Will Price Transparency Be Implemented?
Trump’s new plan advocates for insurers and providers to disclose pricing, profits and claim denial rates in “plain English”. While this move would be widely popular among Americans since health prices are largely hidden from patients, the unpredictability of healthcare makes this difficult to implement. As an example, consider going to the emergency room for an emergency visit for abdominal pain. It would be extremely difficult to predict one’s bill prior to going to the hospital, as one’s care can evolve during a hospital visit. While in the hospital, a patient’s condition can deteriorate, necessitating different imaging studies, medications and services that all can increase cost. A bill for one patient coming to the emergency room for abdominal pain can be on the order of thousands of dollars different than another patient also coming for abdominal pain based on services that are needed in real time.
The Great Healthcare Plan will reset the conversation around consumer choice, price transparency and direct control of financial funds. However, without specific details on implementation, many of its promises remain speculative.
