Trump announces health care plan but Congress must OK it

President Donald Trump called on Congress to lower health care costs as he released a proposal he dubbed “The Great American Health Care Plan.”

The plan was announced Thursday, the same day in which open enrollment for coverage under the Affordable Care Act marketplace closed for the year.

Administration officials described the Trump plan as a broader effort to rein in health costs, including lowering prescription drug prices, redirecting government subsidies from insurers to consumers and expanding price transparency requirements.

The Trump proposal includes a number of provisions that the president has championed.

• Lowering drug prices. The plan calls for codifying the administration’s most-favored-nation deals to get Americans the same prices for prescription drugs that people in other countries pay. Voluntarily negotiated deals between drug companies and the Department of Health and Human Services will be grandfathered into the bill. The bill also would make more prescription drugs available for over-the-counter purchase.
• Lowering insurance premiums. The plan would end tax subsidies that currently enable Americans to buy health insurance on the ACA marketplace and instead would send that money directly to eligible Americans to allow them to buy the health insurance of their choice.  The proposed bill would fund a cost-sharing reduction program for health care plans, which the Congressional Budget Office said would save taxpayers at least $36 billion and reduce the most common ACA plan premiums by more than 10%. The plan would end the kickbacks paid by pharmacy benefit managers to brokerage middlemen.
• Holding insurers accountable. The proposal requires health insurance companies to publish rate and coverage comparisons upfront on their websites in plain English so consumers can make better insurance purchasing decisions. The plan will require health insurers to publish on their websites the percentage of their revenues that are paid out to claims versus overhead costs and profits, and publish the percentage of insurance claims they reject and average wait times for routine care.
• Price transparency. The plan requires all health care providers and insurers to disclose to their patients up front the prices they will be charged.

The announcement of the health plan came as Congress has been unable to come to an agreement on enhanced ACA tax credits that expired at the end of last year, resulting in out-of-pocket premium costs doubling for millions of people.

Last week, the House of Representatives passed a bill giving a three-year extension to enhanced subsidies for those who buy health insurance on the ACA marketplace. The bill is in the Senate, where a bipartisan group of senators is attempting to make progress on a bill that could extend the credits while instituting new income caps for eligibility and lengthening the ACA open enrollment period to soften the blow of premium hikes.

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Susan Rupe is editor in chief, magazine, for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected].