The Trump administration announced a plan aimed at lowering health care costs in the U.S. on Thursday, just as Affordable Care Act open enrollment ends in most states. But the plan lacks key details and largely restates proposals President Donald Trump has previously outlined.<\/p>\n\n\n\n
The proposal, dubbed \u201cThe Great Healthcare Plan,\u201d is being framed by administration officials as a broader effort to rein in health costs, including lowering prescription drug prices, redirecting government subsidies from insurers to consumers and expanding price transparency requirements.<\/p>\n\n\n\n
Trump has been promising a health care plan overhaul for months. The outline for the plan lands as Republicans in Congress negotiate for a bill to extend the enhanced ACA tax credits, which expired Dec. 31 and led to higher premiums for millions of people. The Senate is set leave for a weeklong recess, further diminishing any chance of a deal.<\/p>\n\n\n\n
The Trump proposal also comes as more people voice concerns about affordability issues in the U.S.<\/p>\n\n\n\n
Trump has previously pitched sending federal funds directly to patients to address skyrocketing premiums under the ACA.<\/p>\n\n\n\n
\u201cThe government is going to pay the money directly to you,\u201d Trump said in a video the White House released. \u201cIt goes to you, and then you take the money and buy your own health care.\u201d<\/p>\n\n\n\n
Direct payments and other proposals, however, would require action from Congress, raising questions about how quickly \u2014 or whether \u2014 they could be implemented.<\/p>\n\n\n\n
\u201cWhen it comes to health reform, the devil is in the details, and this is very light on details,\u201d said Cynthia Cox, the director of the program on the ACA at KFF, a nonpartisan health policy research group.<\/p>\n\n\n\n
On Monday, the federal government released data showing ACA sign-ups are running more than 800,000 lower compared with the same time last year.<\/p>\n\n\n\n
During a call with reporters Thursday, administration officials offered no details on how the government would distribute money directly to patients, how large those payments would be or who would qualify.<\/p>\n\n\n\n
The official said the administration is giving Congress \u201cbroad\u201d leeway to decide how the direct payments would work.<\/p>\n\n\n\n
\u201cWe want to start to see that money moved directly to people,\u201d an administration official said. \u201cThere are a lot of different ways that could take place. We are open to working with Congress on how to effectuate that.\u201d<\/p>\n\n\n\n
Trump has proposed sending funds to people\u2019s health savings accounts, which they could use to help cover out-of-pocket costs, such as deductibles and copays \u2014 which Dr. Mehmet Oz, the administrator of the Centers for Medicare & Medicaid Services, also suggested on the call.<\/p>\n\n\n\n
\u201cDirecting it directly to the American people who are eligible, it will allow them to buy health insurance and other programs like health savings accounts of their choice, use that money more wisely,\u201d Oz said.<\/p>\n\n\n\n
Art Caplan, the head of the medical ethics division at NYU Grossman School of Medicine in New York City, said sending money directly to people doesn\u2019t work in the health care space, adding that the plan asks people to be \u201csavvy shoppers.\u201d<\/p>\n\n\n\n
\u201cIt\u2019s a broken plan and a broken idea,\u201d Caplan said. People are \u201ceasily ripped off. The average consumer doesn\u2019t really have time to go shopping when they need to go to the hospital for a premature birth or a car accident.\u201d<\/p>\n\n\n\n
Cox said the plan could send the ACA marketplace into a \u201cdeath spiral.\u201d<\/p>\n\n\n\n
The Obamacare tax credits don\u2019t go directly to insurers as extra money. They\u2019re applied to a person\u2019s monthly premium bill each month, lowering the amount they owe. Without the credits, many people wouldn\u2019t be able to afford their monthly premiums.<\/p>\n\n\n\n
\u201cIt has the potential to severely impact the stability of the ACA marketplaces,\u201d Cox said. \u201cAnd leaving people with pre-existing conditions without an option for comprehensive coverage.\u201d<\/p>\n\n\n\n
The administration official said the plan does not \u201cclose the door\u201d on ongoing negotiations to extend the enhanced subsidies. This month, the House passed a bill to extend the credits for three more years, and the Senate is drafting its own separate version. Trump, however, has suggested he might veto an extension.<\/p>\n\n\n\n
Trump\u2019s preference, the administration official said on the call, is to send the money directly to patients.<\/p>\n\n\n\n
On Thursday\u2019s call, Oz also touted Trump\u2019s \u201cmost favored nation\u201d drug pricing push, which ties U.S. prices to those paid in other wealthy countries.<\/p>\n\n\n\n
Trump first announced that initiative last May, and the administration has so far reached agreements with 14 major drugmakers.<\/p>\n\n\n\n
Oz also highlighted TrumpRx, the new self-pay prescription drug platform that is expected to launch later this month.<\/p>\n\n\n\n
Experts have questioned how much people would actually save on the platform, since most insured patients already get lower prices through their coverage and the Medicaid program pays some of the lowest rates. What\u2019s more, some of the drugs that will be on the platform already have generic versions that are typically cheaper for patients, and the drugs that don\u2019t have generics are used by a relatively small group of people.<\/p>\n\n\n\n
The administration urged Congress to pass legislation \u201cwithout delay,\u201d saying it would deliver relief from what it called the \u201cUnaffordable Care Act\u201d \u2014 a quip often used by Trump to criticize the program\u2019s high costs.<\/p>\n\n\n\n