President Trump's Great Healthcare Plan: How Insurers Are Impacted?

On Jan. 15, 2026, President Donald Trump unveiled the “Great Healthcare Plan,” a sweeping proposal aimed at reshaping how healthcare is priced, purchased, and regulated in the United States. Framed around the promise of “better healthcare for less money,” the plan outlines four core objectives: reducing prescription drug prices, lowering insurance premiums, expanding price transparency and holding large insurance companies more accountable.

At its core, the proposal seeks to redirect government healthcare spending away from insurers and intermediaries and toward individuals. While the plan is ambitious in scope, it requires Congressional approval, and several consequential elements still require detailed implementation guidance, leaving insurers, providers and patients weighing potential outcomes.

Let’s dig deeper.

One of the most prominent elements of the plan is its approach to prescription drug pricing. The proposal seeks to lock in the significant discounts currently being pursued through the administration’s most-favored-nations drug pricing agreement. According to the President, this approach could lower drug prices by as much as 80% to 90% in certain cases.

The administration also expects the plan to reduce insurance premiums by eliminating what it describes as government payoffs to large insurance companies. Instead of subsidizing insurers directly, the redirected funds would go straight to individuals, giving them more control over their healthcare choices.

Supporters of the proposal argue that this shift could increase competition among insurers and reduce costs for consumers. However, the mechanics of how subsidies would be distributed and how eligibility would be determined are yet to be fully detailed.

Transparency Boost

Another major component of the plan focuses on increasing transparency and accountability within the industry. Insurers would be required to publish detailed information about their financial operations, including how much they pay out in claims compared to how much they retain in profits.

The proposal would also force insurers to disclose data on claims denials, including how many claims are denied and how often those denials are overturned on appeal. The administration believes this level of transparency would expose unfair practices and empower consumers to make more informed decisions when selecting coverage.

Beyond insurers, the plan would impose new transparency requirements on hospitals and other healthcare providers that accept Medicare or Medicaid. These entities would be required to prominently display all prices. The goal is to ensure that patients are not surprised by unexpected medical bills and can more easily compare prices across providers. By making pricing information readily available, the administration hopes to encourage cost discipline across the healthcare system.

Criticism and Concerns Emerge

Despite its stated objectives, the Great Healthcare Plan has drawn criticism from policy experts and healthcare stakeholders, many of whom are seeking additional clarity on implementation details.

Cynthia Cox, senior vice president at KFF, has warned that certain provisions could trigger a “death spiral” in the insurance market. Cox expressed concern that individuals with pre-existing conditions, particularly those who do not receive coverage through their employers, could struggle to find comprehensive insurance options.

According to The Guardian report, Miranda Yaver, an assistant professor at the University of Pittsburgh, echoed similar concerns, noting that while healthier individuals may experience cost savings, the plan may not provide sufficient protection for people with pre-existing medical conditions.

Additionally, if enhanced Affordable Care Act tax credits are not extended, out-of-pocket premiums for millions of members are expected to rise significantly in 2026, potentially pushing many individuals out of coverage altogether.

Implications for Health Insurers

Premiums are largely driven by factors including medical costs, administrative expenses and targeted margins. Forcing premium reductions without corresponding declines in medical or administrative costs could directly impact insurer profitability.

Companies such as UnitedHealth Group Incorporated UNH, Centene Corporation CNC, Humana Inc. HUM and Elevance Health, Inc. ELV could face continued pressure as they attempt to stabilize operations in 2026. Marketplace plans may become less predictable revenue sources, especially if enrollment declines. If changes to subsidies or higher premiums lead people to drop coverage, insurers may be left with smaller, less healthy risk pools, increasing overall medical costs and putting upward pressure on expenses.

While UnitedHealth currently has a Zacks Rank #3 (Hold), Centene and Elevance have a Zacks Rank #4 (Sell), and Humana has a Zacks Rank #5 (Strong Sell).

You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.

Pharmacy benefit managers (PBMs) are also targeted multiple times in the administration’s broader effort to lower drug prices. PBMs such as Optum Rx of UnitedHealth, CarelonRx of Elevance and Humana Pharmacy Solutions will likely face pressure if rebate reform and enhanced transparency requirements are enforced.

New disclosure and transparency requirements will likely lead to increased compliance costs for insurers as they adjust reporting systems. Also, if consumers can easily compare insurers and providers on cost and quality metrics due to added transparency, it will intensify competition in the healthcare space. This can lead to a shuffle in the market share of the insurers.

Bottom Line

The Great Healthcare Plan proposes significant changes to healthcare funding flows, transparency standards and drug pricing controls. While the plan aims to lower costs and increase accountability, it remains subject to Congressional approval and lacks key implementation specifics at the moment. The changes could both pressure insurer revenue and operating models, and make markets more competitive. As a result, the ultimate impact on insurers, providers and consumers will depend heavily on how the proposal is refined and enacted by lawmakers.

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This article originally published on Zacks Investment Research (zacks.com).

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