The White House unveiled Donald Trump’s long-awaited health care proposal, which would implement and fund a new cost-sharing plan aimed at driving down premiums for plans on the Affordable Care Act exchanges while also providing direct payments to Americans.

Likely to be put into legislation in the form of health savings accounts, the president’s direct payments would be a substitute for the direct federal subsidies for Obamacare plans in the form of premium tax credits passed in 2022. Those tax credits affected the vast majority of plans on the exchanges.

Coupled with the new federally subsidized cost-sharing plan, the payments are aimed at offsetting the subsidies that expired in December. Millions of Americans were left facing massive rate increases for their plans in 2026 as Congress left in December without finding a legislative path to extend the premium tax credits.

The White House plan also calls for a crackdown on pharmacy benefit managers and broadening the scope of medicines that can be purchased over-the-counter, which the administration hopes will cut down on doctor’s appointments. It also asks Congress to codify the “most-favored nation” status the White House has used to secure trade agreements aimed at lowering drug prices.

White House press secretary Karoline Leavitt claimed that the plan was "the most comprehensive and bold agenda to lower healthcare costs to have ever been considered” at her Thursday briefing.