President Trump on Thursday signed an executive order to expand private Medicare Advantage plans, bashing Democratic proposals for a government-run Medicare-for-All system as socialism and positioning himself as a defender of private insurance and the existing health care program for seniors.
"Medicare is under threat like never before," Trump said in a campaign-style speech delivered at The Villages, a heavily Republican retirement community outside Orlando, to an audience that occasionally broke into chants of “four more years.”
“They want to raid Medicare to fund a thing called socialism,” he said of Democrats, continuing a key theme of his re-election campaign. Behind him, the backdrop read "GREAT HEALTHCARE FOR YOU."
Trump defended his administration’s record on health care and pledged to protect patients with pre-existing medical conditions, despite his administration’s efforts to have the Affordable Care Act, which includes such protections, ruled unconstitutional. The president also promised to end surprise medical bills and to allow the importation of lower-priced prescription drugs from countries including Canada. And he vowed to deliver a “fantastic” Obamacare replacement plan if he’s re-elected next year and Republicans win control of both houses of Congress.
A focus on Medicare Advantage: Trump then signed an executive order to expand supplemental benefit options and telehealth services under Medicare Advantage, an increasingly popular alternative to traditional Medicare that’s administered by private insurers.
Enrollment in Medicare Advantage plans has nearly doubled over the past decade, rising to 22 million, or just over a third of those covered by Medicare overall. Medicare Advantage critics say the plans boost private insurers at taxpayer expense. The Government Accountability Office reported in 2016 that the plans overbilled the government by billions of dollars, The Wall Street Journal notes.
Trump’s executive order “also appears to include a grab bag of proposals, including removing ‘unnecessary regulations that get in between patients and their doctors,’ new online tools to help people choose their Medicare plans, quicker access to ‘breakthrough treatments,’ and better access to medical information, according to Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, who spoke to reporters in a briefing call Thursday,” NPR reported.
The order also says it seeks to “protect and improve the Medicare program by enhancing its fiscal sustainability through alternative payment methodologies that link payment to value, increase choice, and lower regulatory burdens imposed upon providers.”
The order had been titled "Protecting Medicare from Socialist Destruction," but was renamed, "Protecting and Improving Medicare for Our Nation's Seniors."
“We are making your Medicare even better,” Trump told the crowd. “As long as I’m president, no one will lay a hand on your Medicare benefits.”
Can Trump find a health-care message? The Trump administration’s approach to health care includes efforts to push alternatives to Obamacare and give more control to states. But the administration has struggled to push through a number of substantive proposals, and some of the actions Trump touted Thursday have had limited success. Democrats rode a health care message to retake control of the House in 2018 and they’re sure to hammer Trump’s efforts to dismantle Obamacare as part of the 2020 campaign.
“President Trump’s announcement today is nothing more than a thinly veiled effort to disguise his Administration’s dismal record on health care and protecting seniors,” House Majority Leader Steny Hoyer said in a statement Thursday. “This executive order is an admission that the President and Republicans are worried that American voters can see through their health care ploys.”
Without an overarching reform proposal or progress on legislative proposals in Congress, health care may remain a vulnerability for Trump — hence the focus on protecting the current system and defending Medicare as it exists now. “The speech is a part of the White House's efforts to put Trump's health care agenda at the forefront of his reelection campaign, hoping to attract swing voters uncomfortable with his attacks on the Affordable Care Act or a fully government-run health care system championed by two of his chief 2020 Democratic rivals, Sens. Bernie Sanders and Elizabeth Warren,” Politico’s Rachel Roubein writes.
But Trump veered away from health care multiple times during his speech — revisiting the 2016 election, commenting on Elizabeth Warren’s surge in the Democratic presidential primaries and accusing Democrats of pursuing impeachment “because they know they can't beat us fairly" — providing another reminder of just how difficult it may be for him to keep focused on a policy area voters say matters greatly to them.
Still, Trump could yet find a winning message on health care. The Wall Street Journal’s Stephanie Armour reports that Trump believes “his focus on lowering costs will appeal more than Democrats’ pledge to expand coverage.” And a steady drumbeat of attacks criticizing Democrats for supposedly trying to take away Medicare could still resonate with seniors. “I don’t think it’s inherently a threat to the integrity of the program, but I can see the elderly may be nervous about anything that changes the program,” David Blumenthal, president of the Commonwealth Fund, told the Journal.