WASHINGTON, D.C. — President Donald Trump has called on Congress to enact what he calls the “Great Healthcare Plan,” a proposal aimed at lowering insurance premiums, reducing prescription drug prices, and forcing new transparency across the U.S. healthcare system.

Outlined in a White House fact sheet, the plan does not repeal the Affordable Care Act, but would significantly change how federal healthcare dollars are distributed and how prices are set and disclosed — reopening a long-running debate over affordability and access.

“We will bring transparency, fairness, and real competition to American healthcare,” Trump said in announcing the proposal.

The rollout comes as enhanced ACA premium subsidies expired at the end of 2025, driving higher costs for millions of Americans purchasing coverage on their own.

A Cost-Focused Shift, Not an Obamacare Repeal

The Trump plan is framed as a market-based reset, emphasizing cost discipline rather than expanded coverage mandates.

According to the White House, the proposal would:

  • Redirect healthcare subsidies directly to individuals instead of insurers

  • Expand cost-sharing reduction programs to lower deductibles and copays

  • End pharmacy benefit manager (PBM) rebate practices blamed for higher drug prices

  • Require insurers and providers to publicly disclose prices, profit margins, denial rates, and wait times

  • Tie U.S. prescription drug prices to the lowest prices paid by comparable developed countries

“This plan lowers healthcare costs without taking away protections for patients,” the White House said in its policy summary.

Health policy researchers at the Kaiser Family Foundation note that the ACA largely avoided direct price controls, making international drug pricing one of the proposal’s most significant departures from existing law.

Michigan Consumers: Half a Million ACA Enrollees in Focus

The proposal has immediate relevance in Michigan, where more than 500,000 residents rely on ACA marketplace plans — many of them self-employed workers, gig-economy participants, early retirees, and small-business owners.

With enhanced ACA subsidies now expired, many Michigan enrollees are facing double-digit premium increases in 2026, raising concerns about affordability and coverage retention.

“When subsidies decline, enrollment almost always follows,” analysts at the Urban Institute have warned in coverage studies.

Lower prescription drug prices and expanded cost-sharing reductions could provide relief for some Michigan households, particularly older residents and those managing chronic conditions. However, consumer advocates caution that shifting subsidies more directly to individuals could disadvantage lower-income households if eligibility rules are not clearly defined.

Michigan Businesses and Healthcare Providers Brace for Transparency Rules

Michigan insurers and healthcare providers would face new disclosure requirements under the plan, including public reporting of pricing structures, profit ratios, and claims denial rates.

Business groups have long argued that opaque healthcare pricing limits employers’ ability to control benefit costs.

“Employers need clearer, more predictable healthcare pricing,” the U.S. Chamber of Commerce has said in prior healthcare policy statements.

Hospitals participating in Medicare and Medicaid would also be required to post prices in plain language — a move that could increase competition in major Michigan markets such as Southeast Michigan and West Michigan.

Medicaid Expansion Left Unchanged — For Now

Notably, the proposal does not address Medicaid expansion, which covers more than one million Michigan residents and remains a key revenue source for hospitals across the state.

“Medicaid expansion is foundational for hospital stability in expansion states,” the American Hospital Association has said.

The omission suggests Medicaid would remain intact, at least initially, though future negotiations could revisit the issue.

Bottom Line

Trump’s Great Healthcare Plan does not dismantle Obamacare, but it would fundamentally rebalance the system, emphasizing transparency, competition, and cost control over coverage expansion.

For Michigan — where healthcare is both a major employment sector and a growing household expense — the outcome of the proposal could shape affordability for consumers and cost pressures for businesses in 2026 and beyond.

Whether the plan delivers savings or introduces new uncertainty will depend on how Congress translates the framework into law.