President Donald Trump announced an executive order last week that seeks to protect Medicare for older Americans and strengthen it by providing them with more choices – even the choice to not accept it if they would rather have a private, non-government health plan.
Speaking to residents of the Villages in Ocala, Florida, Trump said while Democrats are seeking to expand Medicare so that “all” Americans can be on government-run socialized medicine, he intends to protect it, keep it for seniors only, and improve it by providing more options within the Medicare Advantage program and reducing its costs.
“Together, we’re creating a healthcare system that protects vulnerable patients, makes healthcare more affordable, gives you more choice and control, and delivers the high-quality care Americans deserve,” Trump told seniors in Florida. “And that’s what we’re doing — we’re strengthening our healthcare system to a level that nobody thought would be possible.”
Though the president’s executive order does not change any current policy by itself, it will launch necessary regulatory proposals by federal agencies, particularly the Department of Health and Human Services (HHS).
Here are five ways Trump’s executive order seeks to strengthen Medicare:
- Brings Medicare up to date and provides more plan choices:
Within a year, Trump would like to see the HHS secretary propose a regulation that enables Medicare “to provide beneficiaries with more diverse and affordable plan choices.”
The president wants to “encourage innovative … benefit structures and plan designs” in Medicare Advantage, the program that allows millions of older Americans to access various private health insurers at lower cost due to Medicare subsidies.
In his order, Trump says he wants to “reduce barriers to obtaining Medicare Medical Savings Accounts” and to “promote innovations in supplemental benefits and telehealth services.”
Building on @POTUS Trump’s recent executive order on #Medicare, @CMSGov is announcing that seniors will have access to MORE high-quality #MedicareAdvantage and Part D prescription drug plans in 2020! https://t.co/BE7ILSx3qV
— Administrator Seema Verma (@SeemaCMS) October 11, 2019
Healthcare analyst Christopher Jacobs, CEO of Juniper Research Group, explained at the Federalist that Medicare Medical Savings Accounts are “a health savings account-like mechanism that gives beneficiaries incentives to serve as smart consumers of health care.”
“To accomplish that last objective, the order references broader access to cost and quality data, ‘improving [seniors’] ability to make decisions about their health care that work best for them,’” Jacobs noted.
Younger Americans are gradually becoming more aware of the costs of healthcare services and prescription drugs. Many are using apps that help them assess the cost of a service or drug by various providers and pharmacies. Trump’s order reflects that the practice of deciding what is best for each individual patient does not end when an American turns 65. When more Americans of any age seek the best quality health care at the lowest price, the costs of those services will come down.
- Encourages “enhanced access” to health care:
The implementation of Trump’s executive order would allow more older Americans to access to health care services through telemedicine and other technologies.
Jacobs noted this feature could especially be helpful to seniors in rural areas.
Very importantly, the order also seeks to take on states whose restrictions curtail competition in healthcare access and, thus, lead to limited provider networks in Medicare Advantage plans.
Our redesigned #Medicare Plan Finder has been updated with the 2020 Star Ratings so you can compare the quality of health and drug coverage of different plans as you prepare for the upcoming #MedicareOE! https://t.co/BE7ILSx3qV pic.twitter.com/8x0S5z6RGO
— Administrator Seema Verma (@SeemaCMS) October 11, 2019
- Seeks elimination of regulatory burdens for providers:
The executive order demands further improvement of Medicare by “eliminating burdensome regulatory billing requirements, conditions of participation, and other requirements that serve as obstacles to more providers participating in the program, including physician assistants and nurse practitioners.
In a press statement, the Association of American Physicians and Surgeons (AAPS) commended Trump for taking “bold steps toward increasing the ability of American seniors to choose the medical care and insurance options best for them, instead of being trapped within increasingly insolvent government-run programs.”
“AAPS thanks President Trump for the options he is granting seniors, and the physicians who care for them, in Section 11 of the Executive Order aimed at curbing the further encroachment of socialized medicine in the United States,” said AAPS Executive Director Jane M. Orient, M.D.
- Allows Medicare patients to directly receive monetary savings for using healthcare services that provide the best care at the least cost:
Trump’s order wants older Americans to reap the benefits of learning about costs in healthcare services by directly providing them with rebates and allowing them to share in the savings of the updated program.
- Ends the Clinton-era rule that required older Americans who wished to opt out of government-run Medicare Part A to forfeit their Social Security benefits:
The president’s executive order finally demands a change in the 1993 rule that required Medicare and Social Security to be linked together. The Clinton administration wrote the rule that states seniors cannot opt out of Medicare without giving up their Social Security benefits, even though they had been forced to pay into Social Security for years.
The order states:
Within 180 days of the date of this order, the Secretary, in coordination with the Commissioner of Social Security, shall revise current rules or policies to preserve the Social Security retirement insurance benefits of seniors who choose not to receive benefits under Medicare Part A, and propose other administrative improvements to Medicare enrollment processes for beneficiaries.
“It is unethical, not to mention contrary to basic common sense, to insist that American seniors only receive care through Medicare,” said Orient.
Medicare’s Hospital Trust Fund will be depleted by 2026 and over the next 10-15 years, counting the Trust Funds as assets rather than taxpayer liabilities, the Medicare program is only 71% funded under trustees’ unfavorable assumptions, and 91% under favorable assumptions. Giving seniors the ability to escape this faltering program will help ease the looming crisis as well as give American’s access to options that work best for them, not government bureaucrats.
The Clinton-era rule was challenged by a nonprofit group seeking healthcare freedom, but, in 2011, a federal judge ruled in favor of the Obama administration and stated “requiring a mechanism for plaintiffs and others in their situation to ‘dis-enroll’ would be contrary to congressional intent, which was to provide ‘mandatory’ benefits under Medicare Part A and for those receiving Social Security Retirement benefits.”
“Plaintiffs are trapped in a government program intended for their benefit,” U.S. District Judge Rosemary Collyer continued. “They disagree and wish to escape. The Court can find no loophole or requirement that the Secretary provide such a pathway.”
Under Trump’s order, individuals would still be required to pay Medicare taxes, but if they chose private health insurance, they could opt out of the government-run program without forfeiting their Social Security benefits.
Jacobs observed the proposal “stands as a common-sense solution to our entitlement shortfalls.”
“After all, why should we force someone like Bill Gates or Warren Buffett to accept Medicare benefits if they are perfectly content to use other forms of health coverage?” he reasoned.
Orient emphasized the need to increase patient freedom, rather than adopt “Medicare for All,” which will eliminate choice.
“Widening escape hatches from an insolvent program and other looming Medicare changes, that will deteriorate patient care and limit their options, is needed now more than ever,” she said.