President Trump to Unveil New Health Care Plan as ACA Subsidies Near Expiration

U.S. Pres­i­dent Don­ald Trump is prepar­ing to announce a new pro­pos­al aimed at tack­ling ris­ing health care costs, as his admin­is­tra­tion seeks to pre­vent a major spike in insur­ance pre­mi­ums fol­low­ing the expi­ra­tion of key Afford­able Care Act (ACA) sub­si­dies. Accord­ing to three sources famil­iar with the mat­ter, the plan could be unveiled as ear­ly as Mon­day.

The upcom­ing pro­pos­al is designed to ful­fill Trump’s pledge to deliv­er a bet­ter alter­na­tive to the ACA’s enhanced sub­si­dies, which cur­rent­ly help near­ly 22 mil­lion Amer­i­cans afford cov­er­age. The effort fol­lows weeks of polit­i­cal grid­lock in Wash­ing­ton, where Democ­rats have refused to reopen the gov­ern­ment with­out a clean exten­sion of the expir­ing pay­ments.

In a deal struck ear­li­er this month, Sen­ate Repub­li­cans agreed to hold a mid-Decem­ber vote on extend­ing the enhanced sub­si­dies in exchange for tem­po­rary gov­ern­ment fund­ing through Jan­u­ary — prompt­ing the White House to draft its own com­pet­ing plan.

The Stakes

If the sub­si­dies expire, the Kaiser Fam­i­ly Foun­da­tion (KFF) warns that insur­ance pre­mi­ums could more than dou­ble in 2026, while the Con­gres­sion­al Bud­get Office (CBO) esti­mates that about 2 mil­lion Amer­i­cans would lose cov­er­age.

Democ­rats are already sig­nal­ing they plan to make the issue a key talk­ing point in next year’s elec­tions, recall­ing the back­lash Repub­li­cans faced in 2018 after their failed efforts to repeal the ACA.

What’s in Trump’s Plan?

While the proposal’s details are still being final­ized, sources say the frame­work being dis­cussed includes tem­po­rary exten­sions of the ACA sub­si­dies with added “guardrails” to lim­it their scope. These may include:

• New income caps to restore lim­its removed in 2021.
• A require­ment that all enrollees pay some lev­el of pre­mi­um, elim­i­nat­ing “zero-pre­mi­um” plans that have drawn crit­i­cism for poten­tial fraud.

The new lim­its would address two main Repub­li­can con­cerns — poten­tial mis­use of sub­si­dies and exces­sive gov­ern­ment spend­ing — while keep­ing the sys­tem afloat until a broad­er over­haul can be devel­oped.

The pro­pos­al could also let cer­tain enrollees redi­rect a por­tion of fed­er­al aid into Health Sav­ings Accounts (HSAs), a move aligned with Trump’s recent calls to give indi­vid­u­als more con­trol over their health spend­ing.

GOP Support and Policy Ideas

Repub­li­can sen­a­tors Rick Scott (Flori­da) and Bill Cas­sidy (Louisiana) have already intro­duced com­ple­men­tary mea­sures. Scott’s plan would allow con­sumers to use sub­si­dies to pur­chase cov­er­age out­side ACA mar­ket­places, while Cassidy’s ver­sion focus­es on let­ting fam­i­lies use the funds for direct health care expens­es such as doc­tor vis­its or pre­scrip­tions.

A third plan, from the Paragon Health Insti­tute, would allow low­er-income enrollees to deposit cost-shar­ing sub­si­dies into HSAs to bet­ter man­age out-of-pock­et expens­es.

Addi­tion­al con­ser­v­a­tive mea­sures under review could expand access to non-ACA health plans and reestab­lish cost-shar­ing sub­si­dies to low­er pre­mi­ums.

Drug Pricing and Broader Goals

Trump is also expect­ed to urge Con­gress to cod­i­fy his “Most Favored Nation” drug pric­ing pol­i­cy, which ties the cost of U.S. med­ica­tions to low­er prices in com­pa­ra­ble coun­tries. The admin­is­tra­tion says this ini­tia­tive has already helped nego­ti­ate vol­un­tary price reduc­tions with phar­ma­ceu­ti­cal com­pa­nies.

What’s Next

A White House spokesper­son declined to con­firm details, say­ing:

“Until Pres­i­dent Trump makes an announce­ment him­self, any report­ing about the Administration’s health­care posi­tions is mere spec­u­la­tion.”

With the sub­si­dies set to expire by year’s end, the polit­i­cal and eco­nom­ic stakes are high. Mil­lions of Amer­i­cans could soon see their health insur­ance pre­mi­ums surge — and both par­ties are rac­ing to claim cred­it for keep­ing costs in check.