President Donald Trump speaks to the Detroit Economic Club at MotorCity Casino on January 13, 2025. (Photo by Ben Solis/Michigan Advance)
WASHINGTON – President Donald Trump unveiled his health care proposals to Congress on Thursday, urging lawmakers to approve several sweeping policy changes “immediately” – but he made no mention of expanded tax credits, the expiration of which has left some Americans with skyrocketing costs.
Health care costs, particularly rising health insurance prices, have become a repeated topic of conversation for politicians of both political parties following last year’s government shutdown, when Democrats repeatedly called on Republicans to extend the Affordable Care Act’s now-expired expanded market plan tax credits.
Trump repeated in a five minute video that he wants Congress to give money directly to Americans to assist offset the cost of health insurance or health care, a proposal that has so far failed to gain the traction needed to advance on Capitol Hill.
Trump did not specify income caps for the direct payments, which would likely be sent to health savings accounts instead of a straightforward check. He also did not say how much monthly or annually lawmakers should provide to Americans, leaving the decision to members of Congress.
“The government will pay the money directly to you. It goes to you, and then you take the money and buy your own health care,” Trump said. “Nobody has ever heard of this, and that’s just the way it is. The big insurance companies lose and the people of our country win.”
The expanded ACA market tax credits, first introduced by Democrats during the coronavirus pandemic, expired at the end of 2025. The subsidies helped keep premiums for about 22 million Americans with these health plans lower than they otherwise would have been.
The House voted earlier this month to keep the expanded tax credits in place for another three years, but the bill has stalled in the Senate as a bipartisan group of lawmakers tries to reach a consensus to two more years of subsidies with significant changes.
Lower drug prices
Trump said in the video that Congress should pass a law requiring prescription drug manufacturers to ensure Americans pay the lowest price in the world for medicines, a policy known as “most favored nation” treatment that he pursued during his second term.
“So instead of Americans paying the highest drug prices in the world for decades, we are now paying the lowest costs paid by any other country,” he said. “So, any other country that pays the lowest cost, we will pay. And the American people will get the savings.”
Trump said the proposed law, which he called “The Big Health Plan,” would require health insurers and health care providers to publicly share easy-to-understand information about what they charge and how much profit they make.
“As the saying goes, sunlight is the best disinfectant. That’s why my plan calls for all insurance companies to publish rate and coverage comparisons in very plain English,” Trump said. “Insurers must publish detailed information about how much of your money they will pay out in claims and how much they will make in profits.”
He said health insurers must detail how many claims they deny and whether those health care payment denials were overturned on appeal.
“And most importantly, every hospital or insurer that accepts Medicare or Medicaid must prominently display all prices at its place of business so that you are never caught off guard and can easily shop for a better deal or better care,” Trump said, however a rule for 2019 created a similar requirement. “We have maximum price transparency and costs will fall enormously.”
Path through Congress
A one-page structure The proposal posted on the White House website does not elaborate on whether Trump wants Congress to approve the policy requests as part of the intricate budget reconciliation process that Republicans used to pass the “big, beautiful” bill this summer, or whether he should negotiate a bipartisan bill with Democrats.
A White House official, speaking to reporters on background briefing to detail the plan and next steps, said the administration expects “all proposals to have broad support among the American people.”
“We expect that both Republicans and Democrats can accept it, so reconciliation would not be necessary,” the official said.
The framework is intended to give lawmakers “broad direction” and allow negotiators to take each bill they write in different directions, the official said, adding the administration is “open to working” with Congress on the details.
“We want to make progress,” the official said. “We don’t give a specific path.”
The official said that omitting any mention of the expired expanded tax credits for people who buy their health insurance on the Affordable Care Act’s marketplace was not intended to shut down ongoing bipartisan talks in the Senate, the official said.
“This is not specifically about the ongoing bipartisan congressional negotiations,” the official said. “It actually means we prefer the money to go to the people rather than the insurance companies.”
Involvement of drug manufacturers
Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services, said in the same conference call with reporters that the framework focuses on “four pillars” that the administration believes need to be codified into law – fixing MFN drug prices, reducing health insurance costs, transparency from health insurers and more pricing information from health care providers.
“Even though we’re taking big actions at CMS, including fines and things like that, it’s important for Congress to say, ‘This is how it will be, this is the law of the land,'” Oz said, adding that he truly believes there can be bipartisan support for at least some of the proposals.
Oz said the government’s approach to reducing the cost of prescription drugs to the lowest levels offered anywhere in the world was not aimed at stifling innovation and reiterated that the legislation was vital to longer-term stability.
“We believe that through codification we will ensure that pharmaceutical companies remain committed to future administrations,” Oz said. “We also believe that by doing it the right way, we will not go too far and create challenges to the continued development of life-saving medicines in the United States.”
He said the Trump administration wants Congress to give the Food and Drug Administration more leeway to switch prescription drugs to over-the-counter ones, potentially leading to more competition and lower prices.
Oz said the price transparency portion of the request would assist Americans get more information about how long it takes to get routine appointments and whether health insurers are able to keep their rates low by frequently denying claims.
