by Jennifer Shutt, Georgia Recorder, [This article first appeared in the Georgia Recorder, republished with permission]

January 15, 2026

WASHINGTON — President Donald Trump outlined his health care proposals to Congress on Thursday, asking lawmakers to approve several broad policy changes “without delay” — but left out any mention of enhanced tax credits whose expiration has left some Americans with skyrocketing costs. 

Health care costs, especially the rising price of health insurance, have become a frequent talking point for politicians from both political parties following last year’s government shutdown, when Democrats repeatedly called on Republicans to extend the now-expired enhanced tax credits for Affordable Care Act marketplace plans. 

Trump reiterated in a five-minute video that he wants Congress to give Americans money directly so they can use it to offset the cost of health insurance or health care, a proposal that has so far been unable to get the traction needed to advance on Capitol Hill. 

Trump didn’t detail any income caps on the direct payments, which would likely be sent to Health Savings Accounts as opposed to a simple check. He also didn’t say how much per month or annually he wants lawmakers to provide Americans, leaving it for members of Congress to hash out. 

“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 health care,” Trump said. “Nobody has ever heard of that before, and that’s the way it is. The big insurance companies lose and the people of our country win.”

The enhanced ACA marketplace tax credits, first implemented by Democrats during the coronavirus pandemic, expired at the end of 2025. The subsidies helped to keep premiums lower than they would have otherwise been for about 22 million Americans on those health insurance plans. 

The House voted earlier this month to keep the enhanced tax credits going for another three years, but the bill has stalled in the Senate as a bipartisan group of lawmakers tries to reach consensus on two more years of the subsidies with significant changes. 

Lower drug prices

Trump said in the video that Congress should approve legislation that requires prescription drug companies to ensure Americans pay the lowest price in the world for pharmaceuticals, a policy known as “most favored nation” that he has pursued during his second term. 

“So instead of Americans paying the highest drug prices in the world, which we have for decades, we will now be paying the lowest cost paid by any other nation,” he said. “So any other nation that’s paying the lowest cost, that’s what we’re going to pay. And the American people will get the savings.”

Trump said the legislative request, which he dubbed “The Great Health Care Plan,” would require health insurance companies and health care providers to publicly share easy-to-understand information about what they charge and how much they make in profit.  

“As the saying goes, sunlight is the best disinfectant. That is why my plan orders all insurance companies to publish rate and coverage comparisons in very plain English,” Trump said. “It requires insurers to publish detailed information about how much of your money they’re going to be paying out in claims versus how much they’re taking in in profits.” 

Health insurance companies, he said, would be required to detail how many claims they deny and whether those refusals to pay for health care were overturned on appeal. 

“And most importantly, it will require any hospital or insurer who accepts Medicare or Medicaid to prominently post all prices at their place of business so that you are never surprised and you can easily shop for a better deal or better care,” Trump said, though a 2019 rule created a similar requirement. “We will have maximum price transparency and costs will come down incredibly.”

Path through Congress

A one-page outline of the proposal posted to the White House website doesn’t detail whether Trump wants Congress to approve the policy requests through the complex budget reconciliation process that Republicans used to approve the “big, beautiful” law this summer or to negotiate a bipartisan bill with Democrats. 

A White House official, speaking on background on a call with reporters to detail the plan and the next steps, said the administration believes the “proposals all have broad support from the American people.”

“We expect both Republicans and Democrats to be able to embrace them, so reconciliation would not be necessary,” the official said.

The framework is intended to provide “broad direction” to lawmakers, leaving negotiators the ability to take any bill they may write in different directions, the official said, adding the administration is “open to working” with Congress on the details. 

“We want to make progress,” the official said. “We’re not laying out a specific path.”

The official said the president leaving out any mention of the expired enhanced tax credits for people who purchase their health insurance from the Affordable Care Act marketplace was not intended to cut off ongoing bipartisan talks in the Senate. 

“This does not specifically address those bipartisan congressional negotiations that are going on,” the official said. “It does say that we have a preference that money goes to people, as opposed to insurance companies.”

Engaging drugmakers

Centers for Medicare & Medicaid Services Administrator Dr. Mehmet Oz said on the same call with reporters that the framework focused on “four pillars” the administration believes must be codified into law — solidifying most favored nation drug pricing, lowering health insurance costs, transparency from health insurance companies and more pricing information from health care providers. 

“Although we’re taking major action at CMS, including fines and the like, having Congress say, ‘This is how it’s going to be, this is a law of the land’ is important,” Oz said, adding that he really does believe there can be bipartisan support for at least some of the proposals. 

Oz said the administration’s approach to bring down the cost of prescription drugs to the lowest level offered anywhere in the world is not intended to impede innovation and reiterated that lawmaking is crucial for longer-term stability. 

“We believe by codifying it, we’ll make sure that the drug companies stay engaged for future administrations,” Oz said. “We also believe that by doing it correctly, we’ll not overreach and create challenges to life-saving drugs being continually evolved and developed in the United States.”

The Trump administration, he said, wants Congress to give the Food and Drug Administration more leeway to convert prescription medications to over-the-counter availability, possibly increasing competition and decreasing prices. 

Oz said the price transparency portion of the request would help Americans to have more information about how long it takes to get routine appointments and whether health insurance companies are able to keep their rates down by frequently denying claims.

Georgia Recorder is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Georgia Recorder maintains editorial independence. Contact Editor Jill Nolin for questions: info@georgiarecorder.com.