Trump announces outlines of health care plan he wants Congress to
consider
[January 16, 2026]
By MICHELLE L. PRICE and ALI SWENSON
WASHINGTON (AP) — President Donald Trump on Thursday announced the
outlines of a health care plan he wants Congress to take up as
Republicans have faced increasing pressure to address rising health
costs after lawmakers let subsidies expire.
The cornerstone is his proposal to send money directly to Americans for
health savings accounts so they can handle insurance and health costs as
they see fit. Democrats have rejected the idea as a paltry substitute
for the tax credits that had helped lower monthly premiums for many
people.
“The government is going to pay the money directly to you,” Trump said
in a taped video the White House released to announce the plan. “It goes
to you and then you take the money and buy your own health care.”
Trump's plan also focuses on lowering drug prices and requiring insurers
to be more upfront with the public about costs, revenues, rejected
claims and wait times for care.
Trump has long been dogged by his lack of a comprehensive health care
plan as he and Republicans have sought to unwind former President Barack
Obama’s signature legislation, the Affordable Care Act. Trump was
thwarted during his first term in trying to repeal and replace the law.
When he ran for president in 2024, Trump said he had only “concepts of a
plan” to address health care. His new proposal, short on many specifics,
appeared to be the concepts of a plan.
Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid
Services, described it to reporters on a telephone briefing as a
“framework that we believe will help Congress create legislation.”
A White House official who was not authorized to speak publicly and
described some details on condition of anonymity said the administration
had been discussing the proposal with allies in Congress, but was unable
to name any lawmakers who were working to address the plan.
Sen. Bill Cassidy of Louisiana, the Republican chair of the Senate
health committee, said in a social media post praising Trump's plan that
his committee “has and will take action on the President's affordability
agenda.”
Few specifics on health savings accounts
The White House did not offer any details about how much money it
envisioned being sent to consumers to shop for insurance, or whether the
money would be available to all “Obamacare” enrollees or just those with
lower-tier bronze and catastrophic plans.
The idea mirrors one floated among Republican senators last year.
Democrats largely rejected it, saying the accounts would not be enough
to cover costs for most consumers. Currently, such accounts are used
disproportionately by the wealthiest Americans, who have more income to
fund them and a bigger incentive to lower their tax rate.
White House press secretary Karoline Leavitt was asked Thursday whether
the president could guarantee that under his plan, people would be able
to cover their health costs. She did not directly answer, but said, “If
this plan is put in place, every single American who has health care in
the United States will see lower costs as a result.”
Enhanced tax credits that helped reduce the cost of insurance for the
vast majority of Affordable Care Act enrollees expired at the end of
2025 even though Democrats had forced a 43-day government shutdown over
the issue.
Sen. Bernie Moreno, R-Ohio, has been leading a bipartisan group of 12
senators trying to devise a compromise that would extend those subsidies
for two years while adding new limits on who can receive them. That
proposal would create the option, in the second year, of a health
savings account that Trump and Republicans prefer.
The White House official denied that Trump was closing the door
completely on those bipartisan negotiations, and said the White House
preferred to send money directly to consumers.
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President Donald Trump speaks at the Detroit Economic Club, Tuesday,
Jan. 13, 2026 in Detroit. (AP Photo/Ryan Sun)
Plan follows massive cuts to health programs
Trump’s plan comes months after the Republicans’ big tax and
spending bill last year cut more than $1 trillion over a decade in
federal health care and food assistance, largely by imposing work
requirements on those receiving aid and shifting certain federal
costs to the states.
Democrats have blasted those cuts as devastating for vulnerable
people who rely on programs such as Medicaid for their health care.
The GOP bill included an infusion of $50 billion over five years for
rural health programs, an amount experts have said is inadequate to
fill the gap in funding.
The White House said Trump's new proposal will seek to bring down
premiums by fully funding cost-sharing reductions, or CSRs, a type
of financial help that insurers give to low-income ACA enrollees on
silver-level, or mid-tier plans.
From 2014 until 2017, the federal government reimbursed insurance
companies for CSRs. In 2017, the first Trump administration stopped
making those payments. To make up for the lost money, insurance
companies raised premiums for silver-level plans. That ended up
increasing the financial assistance many enrollees got to help them
pay for premiums.
As a result, health analysts say that while restoring money for CSRs
would likely bring down silver-level premiums, as Trump says, it
could have the unwelcome ripple effect of increasing many people’s
net premiums on bronze and gold plans.
Lowering drug prices is a priority
Oz said Trump's plans also seeks to have certain medications made
available over the counter instead of by prescription if they are
deemed safe enough. He mentioned higher-dose nonsteroidal
anti-inflammatory drugs and peptic ulcer drugs as two examples.
It was unclear whether the White House is asking Congress to take
steps to make more prescription drugs available over the counter.
For decades, the Food and Drug Administration has had the ability to
do that.
The heartburn drug Prilosec, as well as numerous allergy
medications, are among those the FDA has approved for
over-the-counter sales. The FDA only approves such changes if
studies show patients can safely take the drug after reading the
package labeling. Companies must apply for the switch.
The White House said Trump’s plan would also codify his efforts to
lower drug prices by tying prices to the lowest price paid by other
countries.
Trump has already struck deals with a number of drugmakers to get
them to lower the prices. As part of that, the drugmakers have
agreed to sell pharmacy-ready medicines directly to consumers who
can shop online at the White House's website for selling drugs
directly to consumers, TrumpRx.gov.
TrumpRx did not yet have any drugs listed on Thursday. Oz said drugs
will be available on the website at the end of the month.
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AP Health Writer Matthew Perrone contributed to this report.
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