Rural Health News is a weekly segment of Rural Health Today, a podcast by Hillsdale Hospital.
The biggest headline in American healthcare is The White House’s “Great Healthcare Plan”, which aims to hold insurance companies accountable for their pricing and bring down costs for beneficiaries. According to President Trump, the Affordable Care Act and ObamaCare are “unaffordable scams” designed to make corporations rich. The President’s recent video briefing highlighted unprecedented transparency for insurance payers, calling out Medicare and Medicaid specifically as sources of concern.
So far, this is what we know about The Great Healthcare Plan: the plan will endeavor to lower prices for both prescription and over-the-counter drug prices; lower insurance premiums by eliminating subsidy payments and funding a cost-sharing reduction program; hold big insurance companies accountable with improved transparency around claim payments and denial rates; and maximize the price transparency of any insurers accepting Medicare or Medicaid.
An analysis by a KFF Health News expert poses the following critical questions: Why is the plan contradicting the work the One Big Beautiful Bill did to push subsidies back on the backs of the American people? The President claims the plan will “send the money directly to the American people,” but how exactly will this be achieved, and what does that mean for the Marketplace? Will the plan benefit people with pre-existing conditions who currently rely on the ACA markets? How will eligibility for this vague financial aid be determined?
Ultimately, we need more information before we can evaluate how this will impact patients and hospitals, but rural health is not included in the plan’s language, nor in President Trump’s video presentation of the plan. Following the original announcement, the White House hosted a rural health roundtable to focus on affordability, primarily discussing the impact they expect the Rural Health Transformation Program to have. Unfortunately, there still doesn’t seem to be an understanding that replacing volume-based reimbursement to hospitals with innovative, tech-driven grant mechanisms will not make rural health sustainable. A fact-sheet from the White House even explicitly stated that funding reimbursements for healthcare services does not promote long-term sustainability for rural health facilities. This conclusion is based on a series of details that leaves out relevant and necessary factors to understand healthcare reimbursement.
CMS Director Dr. Mehmet Oz lauded states for their ideas to use this funding, but as we’ve discussed previously, state applications have not been representative of the true needs of rural hospitals. We share the concerns of many rural hospitals that the gap in funding we anticipate seeing over the next 5-10 years will have long-term, devastating damage on the entire infrastructure of our national rural health system, leaving millions of Americans without access to care.
From The White House’s one-page statement on this plan, it’s impossible to know how these goals will be accomplished, and it’s already facing great skepticism from both sides of Congress. The Democratic party has responded to the plan with considerable resistance, and many Senate Republicans have expressed confusion and uncertainty since the plan was announced.
Separate from the President’s plan is a bi-partisan healthcare deal revealed just a few days after the Great Healthcare Plan’s big announcement. The 771-page deal doesn’t renew ACA subsidies, but it does extend telehealth flexibilities through 2027 and the acute care at home waiver program for five years. Medicaid DSH cuts would be delayed to 2028 to protect safety-net hospitals and Medicare rural hospital payments would be extended an extra year for Medicare-dependent hospitals and the Low-Volume Hospital Adjustment. If this plan is going to make it through, Congress will need to act soon to get ahead of a government shutdown and curb the trajectory of the President’s Great Healthcare Plan.
Sources
The White House, “The Great Healthcare Plan,” January 16, 2026, https://www.youtube.com/watch?v=fUzNupJidq4.
The White House, “The Great Healthcare Plan,” January 2026, https://www.whitehouse.gov/wp-content/uploads/2026/01/The-Great-Healthcare-Plan.pdf.
Cynthia Cox, “The ‘Great Healthcare Plan’ Leaves Open Questions for People with Pre-existing Conditions,” January 16, 2026, https://www.kff.org/quick-take/the-great-healthcare-plan-leaves-open-questions-for-people-with-pre-existing-conditions/, KFF Health News.
Meredith Lee Hill et al., “Republicans will be hard-pressed to pass Trump’s ‘Great Healthcare Plan’,” January 20, 2026, https://www.politico.com/news/2026/01/20/trump-health-plan-congress-00734445, Politico.
Andrea Fox, “President Trump, Dr. Oz tout rural health IT investments,” January 20, 2026, https://www.healthcareitnews.com/news/president-trump-dr-oz-tout-rural-health-it-investments, Healthcare IT News.
The White House, “Fact Sheet: President Donald J. Trump Celebrates the Great, Historic Investment in Rural Health,” January 16, 2026, https://www.whitehouse.gov/fact-sheets/2026/01/fact-sheet-president-donald-j-trump-celebrates-the-great-historic-investment-in-rural-health/.
Alan Condon, “Congress pitches bipartisan health package: 8 things to know,” January 20, 2026, https://www.beckershospitalreview.com/hospital-management-administration/congress-pitches-bipartisan-health-package-8-things-to-know/?origin=BHRE&utm_source=BHRE&utm_medium=email&utm_content=newsletter&oly_enc_id=8018I7467278H7C, Becker’s Hospital Review.
Rural Health Today is a production of Hillsdale Hospital in Hillsdale, Michigan and a member of the Health Podcast Network. Our host is JJ Hodshire, our producer is Kyrsten Newlon, and our audio engineer is Kenji Ulmer. Special thanks to our special guests for sharing their expertise on the show, and also to the Hillsdale Hospital marketing team. If you want to submit a question for us to answer on the podcast or learn more about Rural Health Today, visit ruralhealthtoday.com.
