Trump’s “America First Health Plan”: Where Do Seniors Stand?

President Trump mentioned his “America First Health Plan” in his speech last week in Charlotte, North Carolina on Thursday, September 24, and people are confused. The healthcare plan seems to be more of a list of things that the president’s administration failed to do as promised in his 2016 Presidental campaign like eliminating the Affordable Care Act, Obamacare. The list goes on to suggest tweaking insurance offerings, reopening the Canadian drug border,  and some cost reductions for seniors in the Medicare program.

Seniors were among Trump’s most loyal voters in 2016, and he has promised repeatedly to protect the popular Medicare program. But not all his proposals would help the seniors who depend on it. Here is what we know.

Trump’s “America First Health Plan” 

The President’s plan delivers better care, more choice, and lower costs for all Americans,” said HHS Secretary Alex Azar. “Because of the President’s leadership, Americans will enjoy lower drug costs, lower insurance premiums, real access to prices of healthcare services and to their medical records, new protections from surprise bills, and the ability to work with their doctor to determine what treatments make sense for them.”

Here are some of the plan’s major bullet points:

1. Protection of preexisting conditions

The first executive order simply declares it a national policy to protect coverage of people with preexisting conditions, without offering specifics. 

“The historic action I’m taking today includes the first-ever executive order to affirm it is the official policy of the United States government to protect patients with preexisting conditions,” Trump said. “We’re making that official. We’re putting it down in a stamp, because our opponents the Democrats like to constantly talk about it.”

Bye, Bye Obamacare! Obamacare enshrined protections for the sickest Americans to prevent health plans from denying them coverage. Trump has repeatedly promised a new replacement plan, saying the health care law is unworkable. Azar pointed to the high cost of Obamacare plans and argued that they don’t truly cover preexisting conditions if people with chronic illnesses can’t afford their premiums or deductibles.

“If you’re a couple aged 55, living in Missouri, making $70,000 a year, the Affordable Care Act will cost you $30,000 in premiums, with a $12,000 deductible,” Azar said. “ I’m sorry, that’s not affordable coverage.”

2. Candian Drug Border Lifted

In one of the administration’s biggest moves, the Department of Health and Human Services approved a rule last week that allows states to set up programs to import drugs from Canada, where they are cheaper because of the Canadian government limits prices. But Canadian’s Prime Minister Trudeau responded earlier today, Tuesday, September 29, with a big no. 

3. No more surprise medical bills

The second executive order on Thursday states that the administration will ban unexpected bills if Congress doesn’t enact a fix by year’s end. But the directive on “surprise” billing isn’t expected to resolve a long-running dispute over holding patients harmless for sometimes staggering bills for emergency or out-of-network care.

Brian Blase, a former Trump adviser, said this effort could soon help consumers. “Arguably, the No. 1 problem with surprise bills is that people have no idea what prices are before they receive care,” he said. But Loren Adler, associate director of the USC-Brookings Schaeffer Initiative for Health Policy in Los Angeles said the rule would have a “very minor effect” because most consumers don’t look at prices before deciding where to seek care — especially during emergencies.

4. Medicare pricing of insulin lower

With more than 3 million Medicare beneficiaries use insulin to control their diabetes, the price of insulin has been a hot topic for some time now. Trump has continued to promise the lowering of insulin prices and this healthcare plan fulfills that promise.

 Medicare will cap the price of insulin at $35 per prescription starting in 2021 for people getting coverage through some drug plans. 

Save Up To 75% On Things Not Covered By Medicare
Medicare doesn’t cover everything.
Luckily, those on Medicare can now start saving on out of pocket expenses.
Save Up To 75% On Things Not Covered By Medicare
Medicare doesn’t cover everything.
Luckily, those on Medicare can now start saving on out of pocket expenses.
Medicare doesn’t cover everything.
Luckily, those on Medicare can now start saving on out of pocket expenses.

5. The senior drug discount cards

Trump promised to send each Medicare beneficiary a $200 discount card over the next several months to help them buy prescription drugs. The initiative is being done under a specific innovation program and must not add to the deficit. Administration officials Friday could not answer where they will get the nearly $7 billion to pay for what is perceived by many observers as a last-ditch stunt to win votes from older Americans.

“Nobody’s seen this before, these cards are incredible, the cards will be mailed out in coming weeks,” Trump said. “I will always take care of our wonderful senior citizens. Joe Biden won’t be doing this.”

What are the experts saying?

Experts are saying that what little the President did say in his speech about planning directives on patient protections and billing and outlining in a pair of executive orders aren’t likely to yield new safeguards for America’s Healthcare.

Stat News reporter Lev Facher said:

Julie Rovner, chief Washington correspondent for Kaiser Health News, added this:

In Trump’s words…

Since Trump’s campaign in 2016, he has adamantly and fundamentally been against Obamacare and the way the Democratic party ran healthcare during Obama’s presidency. 

“We’ve really become the health-care party — the Republican Party. But nobody knows it,” said Trump.

“Obamacare is no longer Obamacare, as we worked on it and managed it very well,” Trump also said about the law that continues to provide coverage for more than 20 million Americans. “What we have now is a much better plan. It is no longer Obamacare because we got rid of the worst part of it — the individual mandate.”

Additional HHS action in the “America First Health Plan”

  • Issued a final rule – PDF and guidance – PDF from the Food and Drug Administration to open the first-ever pathway for states to use to safely import prescription drugs to lower patients’ drug costs.  
  • Solicited private-sector proposals, as called for in the President’s July executive order, on allowing Americans to get lower-cost FDA-approved drugs – PDF and insulins – PDF from American pharmacies via importation and reimportation.
  • Released the 2021 Medicare Advantage and Medicare Part D Premium landscape, showing that average 2021 premiums for Medicare Advantage plans are expected to decline 34.2 percent from 2017 while plan choice, benefits, and enrollment continue to increase and that Part D premiums will be down 12 percent from 2017, with over 1,600 drug plans offering insulin at no more than $35 per month.
  • Issued a notice of proposed rulemaking from the Health Resources and Services Administration to pass on steep discounts at community health centers on insulin and epinephrine to Americans who are uninsured or have high cost-sharing, including the nearly 3 million health center patients with diabetes.
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