One thing that is fairly clear following Thursday’s announcement by the White House of the proposal of what they’re calling The Great Healthcare Plan is that the Trump administration, and assumedly the GOP on Capitol Hill, have decided to fight the 2026 midterm elections on the question of which side has policies to address the affordability crisis in America.
The administration is certainly busy messaging the positive effects of things they’ve already done on that score, and there are some victories to announce. Gas prices, for example, are lower now than they were a year ago, a function of regulatory pullback and a pro-oil and gas agenda. Rents are down in all of America’s major markets with the exception of Seattle, Philadelphia, and Chicago, three of the worst sanctuary cities for illegal aliens — that’s a win directly tied to the administration’s efforts at enforcing immigration laws and squeezing illegal aliens out of the country. (RELATED: Trump’s Economy Grows 4.3 Percent, Dashing Economists’ Lower Expectations)
But what’s really driving the affordability issues in this country, more than anything else, is insurance — car, home, and health. (RELATED: Is Healthcare ‘Burning’ Yet?)
Car insurance is often a state-level issue. It’s a function of car wrecks, of uninsured drivers who get in car wrecks with insured drivers, of stolen cars. Crime is down, including car theft, and with illegals going home, the volume of uninsured drivers is also down. That hasn’t yet bent rates downward; they’re still expected to increase between one and four percent this year, but that’s at least a stabilization of rates.
Home insurance, likewise, is stabilizing. While we’re not quite in a place where rates are declining, it’s projected that we’ll see three-to-five percent increases this year. Gone are the double-digit increases we’ve had crushing us as ratepayers over the last several years. That we went without a hurricane hitting the mainland U.S. last year is helpful, to be sure, but construction costs are big drivers of the cost of home insurance, and those have yet to abate.
Ahhh, but then there is health insurance, and that’s a disaster.
It’s not a disaster of President Trump’s making, though it sure would have been helpful had the U.S. Senate voted back in 2017 to repeal Obamacare. There are multiple reasons one might believe John McCain is burning in hell; his cackling deathbed vote against that repeal simply to spite the president has to rank atop them. (RELATED: Trump’s Pivot Could Make Health Care Affordable Again)
Democrat insistence on continuing to throw taxpayer money into the smoking hole that Obamacare turned the individual health insurance market into, though, is the proximate cause for the out-of-control, busted centrifuge the country faces.
Which brings us to Thursday.
Trump called on Congress to “enact the Great Healthcare Plan, a comprehensive plan to lower drug prices, lower insurance premiums, hold big insurance companies accountable, and maximize price transparency.” Here are the elements, courtesy of the White House’s press release Thursday…
LOWERING DRUG PRICES: The Great Healthcare Plan lowers prescription drug prices for all Americans by building on President Trump’s historic actions to reduce costs for American patients.
- The Great Healthcare Plan calls for codifying the Trump Administration’s Most-Favored-Nation deals to get Americans the same low prices for prescription drugs that people in other countries pay. This would build off President Trump’s landmark actions that made insulin more affordable in his first term and the successful voluntary negotiations following his recent Executive Order to lower drug prices. Voluntarily negotiated deals with HHS/CMS will be grandfathered in.
- The Great Healthcare Plan makes more verified safe pharmaceutical drugs available for over-the-counter purchase. This will lower healthcare costs and increase consumer choice by strengthening price transparency, increasing competition, and reducing the need for costly and time-consuming doctor’s visits.
There are a ton of moving parts to this, and I’m not dragging the reader into the weeds on them. I’ll say that for a very long time, it’s been problematic that American consumers have been subsidizing drug purchasers around the world, and Most Favored Nation is essentially a writ-large version of the demand-side correction that drug reimportation advocacy sought. The drug companies might not like it, and they’re going to argue that without the status quo pricing structure, it won’t be economic to bring new drugs to market. And maybe that’s true, but when you consider that all of these fabulous pharmaceuticals, which cover the TV airtime like a blanket of snow, are the current foundation of American medicine, and yet we’re seeing a declining life expectancy as a country, maybe it’s more important to make the stuff we have cheaper and more available than to boost R&D.
LOWERING INSURANCE PREMIUMS: The Great Healthcare Plan would execute the President’s vision to send money directly to the American people, lower health insurance premiums, and cut kickbacks that raise insurance premiums.
- The Great Healthcare Plan stops sending big insurance companies billions in extra taxpayer-funded subsidy payments and instead send that money directly to eligible Americans to allow them to buy the health insurance of their choice.
- The Great Healthcare Plan funds a cost-sharing reduction program for healthcare plans which would save taxpayers at least $36 billion and reduce the most common Obamacare plan premiums by over 10 percent according to the Congressional Budget Office.
- The Great Healthcare Plan will end the kickbacks paid by pharmacy benefit managers (PBMs) to the large brokerage middlemen that deceptively raise the cost of health insurance.
All of this stuff should be politically popular, and I haven’t quite figured out how the Democrats would attack it. Big Insurance won’t really like any of this part (though what else is coming, they’ll hate more), but it definitely should find purchase with people stuck in the Obamacare exchanges and getting crushed with sky-high rates.
I still think reforming the non-employer health insurer market with a focus on health savings accounts and creating association health plans — meaning, letting people buy health insurance through their school’s alumni association or their church or men’s club or whatever other organization they’re members of — would go a long way toward fixing this problem, but apparently we’re not there yet.
HOLDING BIG INSURANCE COMPANIES ACCOUNTABLE: The Great Healthcare Plan ends the days of insurance companies using complexity to make it difficult for Americans to hold them to account by creating the “Plain English” insurance standard and requiring insurance companies to prominently post the profits they take out of premiums as well as information on the frequency with which they deny care.
- The Great Healthcare Plan creates the “Plain English” insurance standard by requiring health insurance companies to publish rate and coverage comparisons upfront on their websites in plain English — not industry jargon — so consumers can make better insurance purchasing decisions.
- The Great Healthcare Plan will require health insurance companies to publish the percentage of their revenues that are paid out to claims versus overhead costs and profits on their websites.
- The Great Healthcare Plan will require health insurance companies to publish the percentage of insurance claims they reject and average wait times for routine care on their websites.
Most of this is self-explanatory, but one does notice how strange it is that you need a presidential proposal to get what seem like pretty basic considerations out of the insurance industry. Rate and coverage comparisons in plain English on insurance company websites don’t seem like all that big an ask.
MAXIMIZING PRICE TRANSPARENCY: The Great Healthcare Plan requires any healthcare provider or insurer who accepts Medicare or Medicaid to prominently post their pricing and fees in their place of business and ensure insurance companies are complying with price transparency requirements.
- In President Trump’s first term, he issued historic regulations requiring hospitals and insurance companies to post prices in various forms.
- The Biden Administration failed to enforce these requirements and took no actions to help patients access actual prices.
- The Great Healthcare Plan requires all healthcare providers and insurers to answer to their patients up front on the prices they will be charged—restoring accountability, transparency, and rightly giving power back to patients.
Same observation as above, though this has an even greater import given the rolling revelations of just how much fraud there is in these systems. There is a desperate need for sunlight to disinfect them, if for no other reason than if you can smoke the waste and theft out of them, you might find that healthcare isn’t actually as expensive a commodity as you think it is. (RELATED: The Bureaucracy Has Become the Mission)
Not to mention, you might uncover a greater supply of people willing to get into medicine, which is an otherwise unaddressed issue in this plan.
It’s a good start. One gets the impression this was presented as a least-common-denominator proposal that the Left and the Democrats can’t really oppose, so that when they oppose it anyway, their intractability can be used against them politically.
As for making policy? Let’s not pretend here. Chuck Schumer and his minions will filibuster literally anything Trump or the Republicans bring to the Senate floor. It doesn’t matter whether the Great Healthcare Plan is really great, or good, or lousy. They will filibuster it.
So the real question is whether John Thune and the GOP Senate majority have the sand to blow up the filibuster.
Would this be the bill to do that with?
On a first reading of the plan, I’d say no. I’d say it needs beefing up in the House first. The bill that breaks the filibuster had better be a massive political triumph, or what’s the point?
Nevertheless, Trump is making a real effort at getting in front of affordability. His critics owe the American people an honest response rather than reflexive Trump Derangement Syndrome criticisms of the Great Healthcare Plan.
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