President Donald Trump is gearing up for a major healthcare fight — one that insiders say could be far larger than anything Congress is willing to take on. And according to White House deputy chief of staff James Blair, the administration isn’t just thinking about reform… they’re preparing to move.

Speaking at a Bloomberg Government policy breakfast on Tuesday, Blair made it clear:

“We’re going to have the health care conversation. We’re going to put some legislation forward.”

Blair hinted at a possible bipartisan path, but he didn’t sugarcoat the reality: if Democrats block reform, Republicans can still move ahead using reconciliation — the same mechanism Democrats abused to jam through their COVID stimulus and the misleadingly named Inflation Reduction Act.

But the real headline wasn’t the legislative mechanics.

It was Blair’s blunt assessment:

“The president probably would like to go bigger than the Hill has the appetite for.”

Translation: Trump wants sweeping reform. Congress wants to nibble around the edges.

House Republicans Already Signaling Their Support for a Major Overhaul

At the exact same moment Blair was speaking, House GOP leadership was presenting an internal briefing titled “The Unaffordable Care Act,” highlighting how ObamaCare has collapsed under its own weight:

• 80% premium increases since the ACA passed

• More than 50% of enrollees filing zero claims, meaning taxpayers funded insurance people didn’t even use

• A system propped up by massive subsidies that expire soon — subsidies Democrats literally shut down the government to preserve

Republicans made it clear: if healthcare is going to be fixed, it won’t be through more bailouts for insurers.

Trump: “Send the Money Directly Back to the People”

In classic Trump fashion, the president laid out his position without ambiguity:

“THE ONLY HEALTHCARE I WILL SUPPORT OR APPROVE IS SENDING THE MONEY DIRECTLY BACK TO THE PEOPLE, WITH NOTHING GOING TO THE BIG, FAT, RICH INSURANCE COMPANIES… POWER TO THE PEOPLE!”

He wants:

• Direct payments to Americans

• The ability for individuals to negotiate and shop for their own plans

• An end to giant insurance companies siphoning taxpayer dollars

• Expanded Health Savings Accounts

• Lower premiums through real competition

• Cutting out the bureaucracy Democrats built into the ACA

Trump has always believed healthcare should empower the patient — not Washington, and definitely not corporate middlemen.

Democrats’ Shutdown Tantrum Backfired

Remember: Democrats forced a government shutdown for weeks trying to keep temporary pandemic-era insurance subsidies alive — subsidies padding insurance company profits more than helping families.

Now, with those subsidies ending and ObamaCare’s structural flaws exposed, Trump has the upper hand: the public is seeing exactly who benefits from the current system, and it’s not the average American.

The Second Reconciliation Bill Looms

Republican Study Committee Chairman August Pfluger confirmed:

“Affordability must be addressed. Healthcare needs to be part of reconciliation.”

Meaning the stage is set.

Trump wants big. Congress wants cautious. But with reconciliation available, Trump may get exactly the scale of reform he’s aiming for — whether Democrats like it or not.