The Trump administration announced plans to phase out rebates involving pharmacy benefit managers (PBMs) in an effort to lower health insurance costs for Americans. This initiative, referred to as the Great Healthcare Plan, is geared towards reducing both drug prices and premiums while holding major insurance companies accountable and promoting price transparency.
President Trump recently urged Congress to pass this framework swiftly, stating, “We must do it now to provide immediate relief to Americans,” in a video message discussing the initiative.
The proposal characterizes PBMs as “large intermediaries” that have been instrumental in unintentionally inflating premium costs. By removing the rebates that these PBMs receive, the administration hopes to curtail their profits and influence, although this approach is less extreme than previous threats to eliminate PBMs entirely.
PBMs have faced criticism from various sectors, including healthcare, for their role as middlemen between drug manufacturers, insurers, and pharmacies. They negotiate prices and determine which pharmacies are included in their networks, a power that has significant implications for drug pricing.
Back in May 2025, President Trump expressed intentions to completely eliminate PBMs from the pharmaceutical landscape, asserting that the aim is for the U.S. to pay the lowest global prices for medications.
“We’re going to completely eliminate the big-name intermediaries. Nobody knows who they are,” he remarked at a press conference, emphasizing the necessity of cutting out middlemen to facilitate direct sales of drugs to American consumers at competitive prices.
While President Trump didn’t detail how he would achieve reductions in the influence of PBMs, some large pharmaceutical companies agree that changes are necessary. For example, Eli Lilly noted to FOX Business that lowering prices for U.S. consumers hinges on alleviating the burden imposed by middlemen.
Independent pharmacists often point to PBMs as a significant factor in their financial struggles, claiming they lower reimbursement rates and complicate cost coverage.
In contrast, the Pharmaceutical Care Management Association, which represents PBMs, argues that their role is crucial for negotiating lower costs and that eliminating them may destabilize efforts to control drug pricing.
This rewrite of health cost policies also includes plans to redirect taxpayer money away from big insurance companies towards eligible Americans, ensuring they receive desirable health insurance options. Additionally, it aims to fund the Affordable Care Reduction Program, projected to save taxpayers approximately $36 billion and reduce typical Obamacare premiums by over 10%, according to Congressional Budget Office estimates.
