President Trump has finally unveiled his long-awaited plan to reform healthcare, dubbed the “Great Healthcare Plan,” that focuses on codifying the “most favored nation” deals for cheaper drugs from pharmas as well as funding a cost-sharing reduction program for health insurance plans.
The GHP also calls for ending kickbacks paid by pharmacy benefit managers to brokerage middlemen.
In addition to codifying the MFN program, the plan also calls for having more prescription 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,” according to a White House fact sheet.
Regarding insurance premiums, for those who get their coverage through state health exchanges, subsidy payments would be given to individuals directly instead of insurers to buy a plan of their choosing.
A cost-sharing reduction program would save taxpayers at least $36B—though over what period is unclear—and cut the most common ACA plan premiums by more than 10%, the White House said, citing the Congressional Budget Office. Details were not provided.
Insurers will also have to provide information in “Plain English” rather than “industry jargon” to make them more accountable. They will also need to prominently publish rate and coverage comparisons, the percentage of their revenues that are paid out to claims compared to overhead costs and profits, and the frequency of claim denials.