President Donald Trump on Thursday announced the outlines of a health care plan he wants Congress to consider, centering on a proposal to send money directly to Americans through health savings accounts.
In a taped video released by the White House, Trump said, “The government is going to pay the money directly to you,” adding, “It goes to you and then you take the money and buy your own health care.”
White House officials and top administration figures described the proposal as a framework for legislation. Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, described it to reporters on a telephone briefing as a “framework that we believe will help Congress create legislation.”
The plan also lays out changes aimed at lowering prescription drug costs and increasing insurer transparency. Under the proposal described by the administration, insurers would be required to be more upfront with the public about costs, revenues, rejected claims and wait times for care.
The White House did not provide details on how much money would be sent to consumers, or on which Affordable Care Act enrollees would be eligible. A White House press secretary, Karoline Leavitt, was asked whether the president could guarantee that people would be able to cover their health costs. She did not directly answer the question, but said, “If this plan is put in place, every single American who has health care in the United States will see lower costs as a result.”
Democrats have rejected the health savings account idea, arguing it would not be sufficient as a substitute for the tax credits that helped lower monthly premiums for many people. The AP reported that the accounts are used disproportionately by the wealthiest Americans, who have more income to fund them and a bigger incentive to lower their tax rate.
The announcement comes as Republicans face pressure to address rising health costs after certain Affordable Care Act subsidies expired at the end of 2025. The AP said Democrats forced a 43-day government shutdown over the issue, and that Sen. Bernie Moreno of Ohio is leading a bipartisan group of 12 senators seeking a compromise to extend the subsidies for two years while adding new limits on who can receive them.
Under that bipartisan approach, the AP reported that a health savings account option would be created in the second year, aligning with the accounts Trump and other Republicans prefer. A White House official, speaking on condition of anonymity, denied that the administration was closing the door completely on the bipartisan negotiations and said the White House preferred sending money directly to consumers.
Trump’s health-care proposal also follows last year’s large Republican tax and spending bill that cut more than $1 trillion over a decade in federal health care and food assistance, including by imposing work requirements on some aid recipients and shifting some federal costs to states. The AP reported that Democrats criticized the cuts as devastating for vulnerable people who rely on programs such as Medicaid, while the GOP bill included a $50 billion infusion over five years for rural health programs that experts said would be inadequate to fill the funding gap.
For premium costs, the White House said Trump’s plan would seek to bring down premiums by fully funding cost-sharing reductions, a form of financial help that insurers provide to low-income Affordable Care Act enrollees on silver-level plans. The AP said the federal government reimbursed insurers for cost-sharing reductions from 2014 until 2017 and that payments stopped in 2017 under the first Trump administration; insurance companies then raised silver-level premiums, increasing the financial assistance many enrollees received.
Health analysts cited by the AP said restoring cost-sharing reductions would likely bring down silver-level premiums as Trump says, but could create a ripple effect by increasing many people’s net premiums on bronze and gold plans.
Oz also said Trump’s plan seeks to make some medications available over the counter instead of by prescription if they are deemed safe enough, including examples such as higher-dose nonsteroidal anti-inflammatory drugs and peptic ulcer drugs. The AP reported it was unclear whether the White House was asking Congress for additional steps to expand over-the-counter options, noting that the Food and Drug Administration already has authority to approve such changes when studies show patients can safely take the drugs after reading package labeling.
On drug pricing, the White House said Trump’s plan would codify efforts to lower costs by tying prices to the lowest price paid by other countries. The AP also reported that Trump has already reached deals with drugmakers to lower prices, including an agreement for pharmacy-ready medicines to be sold directly to consumers through TrumpRx.gov; the AP said the website did not yet list any drugs on Thursday, and that Oz said drugs would be available on the site at the end of the month.
Trump’s proposal drew support from Sen. Bill Cassidy of Louisiana, the Republican chair of the Senate health committee. Cassidy wrote in a social media post praising the plan that his committee “has and will take action on the President’s affordability agenda.”