Trump Expected to Unveil New Health Care Cost Proposal/ Newslooks/ WASHINGTON/ J. Mansour/ Morning Edition/ Trump is set to propose a plan to offset rising health care premiums. The plan would partially extend ACA subsidies with added restrictions. GOP seeks tighter rules and lower fraud in future ACA coverage.
Trump Health Care Proposal: Quick Looks
- Trump expected to announce new health care proposal soon
- Plan responds to expiring enhanced Affordable Care Act subsidies
- Nearly 22 million Americans rely on current ACA aid
- GOP aims to limit subsidy scope and reduce fraud
- Premiums could more than double if aid expires
- Proposal includes income caps, premium requirements for all enrollees
- Savings accounts may replace some federal ACA payments
- Republicans divided on subsidy structure and HSA options
- Democrats plan to use fallout in 2026 midterm campaigns
- Trump also seeks to revive drug pricing reform policy
Trump Will Unveil New Health Care Cost Proposal
Deep Look
President Donald Trump is preparing to reveal a new health care cost proposal designed to address the looming expiration of enhanced Affordable Care Act (ACA) subsidies, potentially as early as Monday. With millions of Americans facing sharp increases in premiums next year, the proposal represents the GOP’s latest effort to shape post-COVID health policy—and revive Trump’s vow to offer a “better alternative” to Obamacare.
According to three individuals familiar with the matter, Trump’s team is finalizing a framework that would temporarily extend the subsidies while introducing new constraints. The measure comes amid a prolonged government shutdown standoff, during which Democrats have demanded a clean renewal of the ACA subsidies. In response, Senate Republicans have agreed to vote in mid-December on an extension, prompting Trump’s camp to craft a rival vision.
The beefed-up subsidies, originally enacted as part of a 2021 COVID-19 relief package, are set to lapse at the end of the year. Their expiration would significantly raise health insurance costs for many, potentially doubling premiums in 2026. A report from the nonpartisan KFF (Kaiser Family Foundation) projects millions of Americans could lose coverage, with the Congressional Budget Office estimating roughly 2 million could become uninsured.
Trump’s plan aims to soften that blow while responding to long-standing conservative critiques. The proposal under consideration includes reinstating income limits for eligibility, returning to the previous 400% federal poverty level cap that was removed under the enhanced subsidies. This rollback would impact middle-class families who benefited most from the subsidy expansion.
To combat alleged abuse in the system, the plan would also mandate that all enrollees pay at least a minimal premium. Republican lawmakers argue that the existence of zero-premium plans has opened the door to fraudulent practices, with brokers enrolling clients without their consent in exchange for commission payouts. Reintroducing a cost-sharing requirement, even for lower-income Americans, is designed to curb such exploitation.
Additionally, the proposed framework is expected to include provisions allowing some enrollees to divert their federal subsidy dollars into health savings accounts (HSAs). These accounts could be used for qualifying medical expenses or to purchase health insurance—potentially even outside the ACA’s regulated marketplace.
This approach aligns with recent proposals by GOP senators. Sen. Rick Scott of Florida has advocated for full flexibility, allowing consumers to use all federal health aid to shop for plans, including those outside ACA parameters. Sen. Bill Cassidy of Louisiana has taken a more moderate stance, suggesting only the enhanced portion of the subsidies be shifted to HSAs to cover direct medical costs like doctor visits, prescriptions, or vision care.
Meanwhile, the conservative-leaning Paragon Health Institute has introduced a model that would extend HSA usage to cover additional subsidies intended to lower deductibles and out-of-pocket costs. The proposal also calls for renewed congressional funding of cost-sharing reductions—another pillar of ACA affordability—aiming to provide consumers more control over their coverage and costs.
Taken together, these concepts signal a larger Republican effort to reshape the ACA from within, rather than seeking full repeal as in prior years. Trump’s version would preserve temporary aid but reintroduce limits that reflect conservative principles of personal responsibility and market choice.
Still, the proposal remains in flux. According to the White House, no formal policy will be confirmed until Trump himself makes the announcement.
“Until President Trump makes an announcement himself, any reporting about the Administration’s healthcare positions is mere speculation,” a spokesperson said in a statement.
Nonetheless, the political stakes are high. With control of Congress up for grabs in the 2026 midterms, Democrats have seized on the potential fallout. They argue that allowing the ACA subsidies to expire would mirror the 2017 repeal efforts that cost Republicans the House in 2018. Democratic strategists are already preparing to make health care a central campaign issue again, particularly if millions see coverage disruptions in the coming year.
In a move likely to draw even more attention, Trump is also expected to renew his push for a “Most Favored Nation” drug pricing law, which would tie U.S. medication costs to the lower prices paid by peer countries. Though previously rolled out via executive action, Trump now aims to have the policy enshrined in legislation.
As the clock ticks toward the end-of-year subsidy deadline, Trump’s health care proposal could set the stage for renewed partisan clashes over health policy—and revive a defining issue of his political legacy.
You must Register or Login to post a comment.