President Trump signed an executive order Thursday aimed at batting back criticism about his administration’s efforts to undo Obamacare and at contrasting himself with liberal Democrats who want enroll everyone in the United States into government healthcare through “Medicare for all.”
“We are making your Medicare even better and it will never be taken away from you,” Trump said. “We are not letting anyone get close. These people on the other side — these people are crazy by the way, they’re totally crazy — they want to take it away and give you lousy healthcare.”
The president delivered his remarks in The Villages, a Florida retirement community, in a speech that top administration said earlier in the day would focus on broadening his healthcare message beyond Obamacare. The focus was on Medicare, the program that covers 65 million seniors and people with disabilities, but also on private health insurance, as changes to Medicare tend to ripple across the healthcare system.
“This president has been focusing on health issues that other administrations have been ignoring for decades,” Joe Grogan, head of the White House’s Domestic Policy Council, said on a phone call with reporters. The number of people enrolled in Obamacare was not, he said, “that many people.”
The part of Obamacare he referred to set up health insurance exchanges that allowed about 9 million people to get private coverage on their own to buy government-subsidized plans.
But Obamacare also created rules that prohibited plans from charging sick people more or from refusing them coverage and let children stay on their parents’ plans until age 26. It enrolled poor people in Medicaid, including seniors who often use it to pay for long-term care. It contains multiple other provisions, such as letting healthcare providers experiment with different payment methods and reducing what seniors pay for their prescriptions.
As more people have gotten to understand the law, the administration has faced criticism by Democrats that it is uncommitted to protecting the sick. Thursday’s executive order, called “Protecting and Improving Medicare For Our Nation’s Seniors,” is meant to push back.
It will allow for private plans that operate in Medicare, known as Medicare Advantage, to add more wellness benefits and to offer more plans, including allowing them to set up savings accounts to pay for care. Other services the program could pay for would include adult day care. The administration will also change regulations that discourage telehealth so that patients can use computers and smartphones to get in touch with their doctors, and will allow the government to pay for newer technologies and treatments soon after regulators approve them.
The administration is looking at taking down regulations that force nurse practitioners and physician assistants to practice under a doctor’s supervision. This move would help to fight the doctor shortage, particularly in rural areas, officials said.
“This is the most comprehensive vision for healthcare I can recall any president putting forth,” said Alex Azar, Health and Human Services secretary.
The administration did not appear to have planned cuts to Medicare to prepare for its sustainability in the long term. Medicare’s portion that pays for hospital care will run out of full funding in 2026, according to the latest Social Security and Medicare trustees report. At that point, the program would pay a diminishing amount of reimbursement for medical costs.
Seema Verma, administrator for the Center for Medicare and Medicaid Services, said that Medicare savings in the traditional government program would go up because the administration would reduce regulations. She noted that premiums under Trump were going down in Medicare Part D, which pays for prescription drugs, affecting how much the program overall is spending.
Some of the plans to be announced reinforce agenda items the administration already has set in motion, including giving people other benefits in Medicare Advantage that allow their plans to pay for nutrition or transportation to a doctor’s office. The administration also put work into improving the website on Medicare that lets people compare health plans.
“The president has made some clear promises on healthcare and he will reinforce those today,” Azar said.
Trump’s speech is part of his reelection bid. “Medicare for all,” the plan from presidential candidate Bernie Sanders to enroll everyone living in the United States into public coverage and to abolish private health insurance, is a divisive issue in the Democratic primary. Sen. Elizabeth Warren of Massachusetts also supports the plan, but she and Sanders have been repeatedly assailed by rival Joe Biden as wanting to raise middle-class taxes. Biden instead has called for expanding Obamacare and let people have the option to buy into a public plan.
Meanwhile, the Trump administration has sided with Republican state officials in a lawsuit, for which a verdict is expected any day, saying that Obamacare should be thrown out. The lawsuit has allowed for Democrats to attack the administration as wanting to strip away healthcare from people with preexisting health conditions.
At the same time, the dispute over healthcare in the Democratic primary is also opening up a line of attack for the president to attack Democrats as radical on healthcare policy. White House officials renewed these attacks in the call Thursday.
Grogan said “Medicare for all” would result in “Medicare for none,” while Verma said it was important for seniors, who paid into the program all their lives, to be able to benefit. Proposals to expand government healthcare were “morally wrong because they would demote America’s seniors to little more than second class citizens,” Verma said.
And in his speech Thursday, Trump said Medicare was “under threat like never before,” given that Democrats wanted to introduce plans that would either give people the option to enroll in a public program or force them into it.
“They are all based on the totally same terrible idea: They want to raid Medicare to fund a thing called ‘socialism,'” he said.
