President Donald Trump published a request on Thursday for Congress to enact various healthcare reforms through what the White House is calling the “Great Healthcare Plan.”
The fact sheet published by the White House outlines that the plan is meant to lower prescription drug prices and insurance premiums for all Americans, as well as maximize price transparency in the healthcare market.
Centers for Medicare and Medicaid Services Administrator Mehmet Oz said the thrust of the announcement was to create a framework to “get to the root causes” of rising healthcare costs.
Oz said the main pillar of the plan will be codifying the president’s “Most Favored Nation” drug pricing policy, which would allow the Department of Health and Human Services to negotiate with pharmaceutical companies to match the lowest prescription prices worldwide.
Since August, the Trump administration has announced more than a dozen successful negotiations with pharmaceutical companies to voluntarily lower prices for medications, including GLP1 weight-loss and diabetes drugs and fertility medications.
“We believe by codifying it, we’ll make sure that these drug companies stay engaged for future administrations,” Oz said.
He also said the plan includes legislation to increase the number of over-the-counter medications available to consumers without a prescription.
“We do think that making verified safe pharmaceutical drugs available over-the-counter will inherently reduce the price, though, because it increases competition and gives more control to consumers to drive for the best price,” Oz said.
The plan also targets what Oz characterized as “kickback” payments for Pharmacy Benefit Managers, which act as middlemen between pharmaceutical and insurance companies.
A bipartisan bill on PBM reform that nearly passed in 2024 has been a central point of agreement in recent months’ healthcare reform talks in Congress. While talks of renewing Obamacare premium subsidies that expired at the end of 2025 appear to have stalled, there has been continued interest in passing the previously abandoned PBM legislation.
The “Great Healthcare Plan” does not include renewing the Obamacare premium tax credits. It instead calls for sending funds directly to patients but lacks a specific proposal for how to send them the money to buy insurance or healthcare services through a partially funded Health Savings Account, which Trump has supported in the past.
Oz said Trump “feels strongly that the money that we’ve been pouring into insurance has often disproportionately gone to insurance companies, not to the people themselves,” which the administration said has not worked in the past.
The “Great Healthcare Plan” would also require health insurance companies to publish the percentage of their revenues that are paid out in claims versus directed toward overhead and profit, as well as the rates of insurance claim rejections and the wait times for prior authorizations to receive needed care.
“By empowering the American people to be able to use the money wisely on their own behalf, that flexibility would drive value into the system,” Oz said.
Oz said he and the president have spoken with insurance companies and that they are “optimistic” they will cooperate.
Trump’s new plan comes as Republicans on the House Budget Committee announced earlier this week their intention to pursue a second budget reconciliation bill, a legislative maneuver that would bypass the 60-vote majority rule in the Senate.
However, senior White House officials said they expect broad bipartisan support for the legislation, which would make the reconciliation process unnecessary.
“Most Favored Nation drug pricing, lowering insurance premiums, maximizing price transparency, and holding big insurance companies accountable. That’s what the President wants Congress to consider,” Oz said. “Leadership has been debriefed. There will be ongoing conversations, and we hope to be able to support them with specific language for the legislation.”
Trump’s plan, announced 10 months before November’s midterm elections, is a response to fears that Republicans could be undermined in the contests due to rising Obamacare health insurance premiums.
On Thursday, a senior administration official said Congress “delivering meaningful healthcare reform and [lowering care] prices as a top priority” for Trump.
In a separate video posted on social media, Trump added, “Instead of putting the needs of big corporations and special interests first, our plan finally puts you first and puts more money in your pocket. The government is going to pay the money directly to you. It goes to you, and then you take the money and buy your own healthcare. Nobody has ever heard of that before, and that’s the way it is.”
“I’m calling on Congress to pass this framework into law without delay,” he said. “[We] have to do it right now, so that we can get immediate relief to the American people, the people I love.”
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The fight over Obamacare was underscored by last year’s historically long federal government shutdown, which Democrats prolonged with their calls to extend pandemic-era Obamacare tax credits.
Trump was also criticized during the 2024 campaign for saying in his one debate against former Vice President Kamala Harris that he had only a “concept of a plan” for healthcare. In his first administration, his legislative reform efforts failed when the late former Republican Arizona Sen. John McCain voted “no.”
