In January 2026, as healthcare costs hit record highs yet again, the administration unveiled the Great Healthcare Plan. While currently more of a “framework” than a final law, this proposal aims to fundamentally shift how prescription drugs are priced, how subsidies are paid, and how much transparency you—as an employer—can actually expect from the system.
Here’s our breakdown of the four pillars and what they mean for your bottom line.
1. Slashing Prescription Drug Prices
The plan’s core focus is reducing the cost of medications by tying U.S. prices to the lower rates paid internationally, known as “Most-Favored-Nation” (MFN) pricing. It also aims to move more safe medications to over-the-counter (OTC) status.
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For Business Owners: This could stabilize renewals for plans with high pharmacy spend. Moving more drugs to OTC may also reduce employee downtime for doctor visits.
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HBC Takeaway: Drug companies have used American insurance plans to line their pockets for decades. While we hope this lowers costs, keep an eye on how “grandfathered” deals might affect your specific plan.
2. Direct Funding: HSAs Instead of Insurers
In a massive shift, the plan proposes redirecting federal subsidy dollars away from insurance companies and directly into individuals’ Health Savings Accounts (HSAs).
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For Business Owners: This could simplify individual coverage options for your team. However, current law prevents HSA funds from being used for premiums—a major hurdle that Congress would need to fix.
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HBC Takeaway: Sometimes the politicians don’t get the complexity. HSAs are great, but until the individual market is “fixed” and PPOs return, this shift could be complicated for the average employee to manage.
3. Lowering Premiums & Ending “Kickbacks”
The plan targets Pharmacy Benefit Manager (PBM) “kickbacks” and brokerage middleman fees that deceptively raise costs. It also proposes a cost-sharing reduction program to cut some premiums by over 10%.
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For Business Owners: Ideally, this leads to more predictable annual spending.
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HBC Takeaway: We’ve seen PBMs operate in the shadows for years. Any move to clean up these “opaque” systems is a win for employers who are tired of hidden fees.
4. Radical Transparency
The plan mandates that insurers and providers who accept Medicare/Medicaid prominently post all pricing and fees in “Plain English”.
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For Business Owners: Transparency empowers you to choose more cost-effective provider networks.
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HBC Takeaway: This information has been “behind lock and key” for too long. You should know exactly what an MRI or surgery costs before the claim is filed. The “file the claim to see the cost” line is nonsense.
Ryan’s Final Takeaway: Optimism vs. Reality
This plan is currently light on implementation details. While the goals are laudable—especially addressing the super-complicated pricing models used by hospitals and drug companies—the real-world impact will depend on Congressional enforcement.
We will stay optimistic and continue to monitor the details as they emerge at greathealthcare.gov. In the meantime, the best way to control your costs is to stay educated and active in your plan design.
How would these changes help your company?
