WASHINGTON, D.C. — In a sweeping bid to upend how Americans pay for healthcare, Donald J. Trump on Thursday unveiled what he is calling The Great Healthcare Plan—a far-reaching proposal that aims to slash prescription drug prices, rein in insurance companies, and route federal healthcare dollars straight into the hands of patients.
At its core, the plan is a blunt rejection of the existing system. Instead of subsidies flowing through insurers, pharmacy benefit managers, and government intermediaries, Trump is proposing that the government “pay the money directly to you,” allowing individuals to purchase coverage and care on their own terms. The White House argues that this shift would fundamentally realign incentives, putting patients—not corporations—at the center of healthcare decision-making.
The proposal arrives at a moment of deep public frustration. Even as national healthcare spending has climbed into the trillions, many Americans report paying more each year for premiums, deductibles, and prescription drugs. Trump’s plan frames that reality as a policy failure, repeatedly targeting what he calls “kickbacks,” “middlemen,” and “one-size-fits-all” mandates that drive up costs while limiting choice.
One of the most aggressive components centers on prescription drugs. Building on a most-favored-nation pricing framework launched by the administration, the plan seeks to lock in international reference pricing so Americans pay no more than the lowest price charged in comparable developed nations. Trump claims the result will be price reductions of 80% or more for some medications, a shift he says would end decades in which U.S. patients paid the highest drug prices in the world.
Insurance markets are another focal point. The plan proposes ending what the administration describes as government payoffs to large insurers and brokers, redirecting those funds into individual healthcare savings accounts. Consumers, the White House contends, would then shop for coverage directly, forcing insurers to compete on price and quality rather than navigating opaque subsidy structures. At the same time, the framework calls for expanded enforcement of price transparency rules, requiring hospitals and insurers that accept Medicare or Medicaid to publicly post prices in clear, plain language.
Supporters say transparency is the linchpin. Under the plan, insurers would be compelled to disclose how much premium revenue goes to patient care versus profits, how often claims are denied, and how frequently those denials are overturned. Hospitals, meanwhile, would be required to post prices prominently, allowing patients to compare costs before receiving care—an idea Trump has repeatedly described as “sunlight” disinfecting a system long shielded from market pressure.
The initiative is paired with a second pillar aimed squarely at rural America. Through the Rural Health Transformation Program created by the Working Families Tax Cuts Act, the administration is directing $50 billion over five years to strengthen rural healthcare access. Beginning in 2026, the program will provide an additional $10 billion annually to rural hospitals and communities, funding that officials say is designed to promote innovation, stabilize facilities with low patient volumes, and modernize care delivery rather than simply reimbursing services after the fact.
Administration officials argue that this approach corrects structural weaknesses that have left rural hospitals financially fragile for decades. By offering flexible funding not tied solely to utilization, the program is intended to help facilities invest in workforce, technology, and new care models suited to sparsely populated regions.
Taken together, The Great Healthcare Plan represents one of the most ambitious attempts in years to rewire the economics of American healthcare. Whether Congress will embrace its central premise—direct payments to patients, hard international price caps on drugs, and sweeping transparency mandates—remains an open question. But the political message is unmistakable: after years of incremental fixes, the White House is betting that voters are ready for a more confrontational reset of a system many believe no longer works for them.
More information on the proposal is available at https://greathealthcare.gov.
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