President Donald Trump greets supporters after arriving at Ocala International Airport, Thursday, Oct. 3, 2019, to give a speech on health care at retirement community, The Villages.
President Donald Trump greets supporters after arriving at Ocala International Airport, Thursday, Oct. 3, 2019, to give a speech on health care at retirement community, The Villages. [Evan Vucci | AP]

Targeting ‘Medicare For All’ Proposals, Trump Lays Out His Vision For Medicare

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President Trump gave a speech and signed an executive order on health care Thursday, casting the “Medicare for All” proposals from his Democratic rivals as harmful to seniors.

His speech, which had been billed as a policy discussion, had the tone of a campaign rally. Trump spoke from The Villages, a huge retirement community in Florida outside of Orlando, a deep-red part of a key swing state.

His speech was marked by cheers and standing ovations, and intermittent chants of “four more years” by an audience of mostly seniors.

Trump spoke extensively about his administration’s health care achievements and goals, and the health policy proposals of Democratic candidates for president, which he characterized as socialism.

The executive order he signed had previously been titled “Protecting Medicare from Socialist Destruction” on the White House schedule, but has since been renamed, “Protecting and Improving Medicare for Our Nation’s Seniors.”

“In my campaign for president, I made you a sacred pledge that I would strengthen, protect and defend Medicare for all of our senior citizens,” President Trump told the audience of retirees. “Today I’ll sign a very historic executive order that does exactly that — we are making your Medicare even better, and … it will never be taken away from you, we’re not letting anyone get close.”

The order is intended, in part, to shore up Medicare Advantage, an alternative to traditional Medicare that’s administered by private insurers. That program has been growing in popularity, and this year, premiums are down and plan choices are up.

According to administration officials, the executive order directs the Department of Health and Human Services to take action to improve several aspects of Medicare, including expanding plan options for seniors, encouraging innovative plan designs, and improving the enrollment process to make it easier for seniors to choose plans.

The 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.

President Trump came into office promising to dismantle the Affordable Care Act, and replace it with something better. Those efforts failed, and the administration has struggled to get substantive policy changes on health care.

On Thursday, the administration emphasized a number of its recent health care policy moves.

“[Trump’s] vision for a healthier America is much wider than a narrow focus on the Affordable Care Act,” said Joe Grogan, director of the White House Domestic Policy Council.

Secretary of Health And Human Services, Alex Azar, said this was “the most comprehensive vision for health care that I can recall any president putting forth.”

He highlighted a range of actions the administration has taken, from a push on price transparency in health care, to a plan to end the HIV epidemic, to more generic drug approvals. Azar described these things as part of a framework to make health care more affordable, deliver better value, and tackle “impassable health challenges.”

Without a big health reform bill, the administration is positioning itself as a protector of what exists now — particularly Medicare.

“Today’s executive order particularly reflects the importance the President places on protecting what worked in our system and fixing what’s broken,” Azar said. “Sixty million Americans are on traditional Medicare or Medicare Advantage. They like what they have, so the president is going to protect it.”

Drawing battle lines through Medicare may be a savvy campaign move on Trump’s part.

Medicare is extremely popular. People who have it like it, and people who don’t have it, think it’s a good thing, too. A recent poll by the Kaiser Family Foundation found that more than eight in ten Democrats, independents, and Republicans think of Medicare favorably.

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