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Trump proposes replacing Obamacare with direct cash payments to Americans

Trump proposes replacing Obamacare with direct cash payments to Americans

On April 2, 2026, President Donald Trump proposed a sweeping overhaul of the US healthcare system, calling for the full repeal of the Affordable Care Act, commonly known as Obamacare, and its replacement with direct cash payments to Americans.
In a post on Truth Social, Mr. Trump argued that the current system artificially inflates medical costs through the role of insurers and said the country should shift to a model that channels payments directly to individuals rather than through insurance companies. The proposal is included in a broader legislative package dubbed the "One, Big, Beautiful Bill Act."
Under the plan, Americans would receive subsidies into personal accounts and would use those funds to select and purchase insurance plans independently. Mr. Trump described the existing law as the "Unaffordable Care Act" and said the new approach would boost market competition and expand the use of health savings accounts (HSAs).
The announcement triggered sharp declines in shares of major health insurers, whose operating profits are closely linked to government subsidy programs. Investors also expressed concern for large pharmacy chains and intermediary services, given administration plans to curb the role of pharmaceutical middlemen.
Implementation has been assigned to the relevant federal agencies that oversee public health programs. Analysts cautioned that a shift to direct payments could pose risks for low‑income households if market prices for insurance exceed the level of government assistance. The White House, however, said it expected greater price transparency and the removal of intermediary markups to deliver long‑term reductions in US healthcare costs.

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