Donald Trump delivered a speech to a large retirement community in Florida on October 3, 2019 to introduce a new executive order on Medicare. The Trump speech and executive order were previously called “Protecting Medicare from Socialist Destruction,” but the title was changed at the last minute with no explanation from the White House. However, the target of Trump’s aggression remained the same: anyone wishing to expand Medicare into Medicare for All.
The speech was meant to inform the audience of seniors at the popular retirement community, The Villages, about the executive order. However, the Trump speech had the tone and rhetoric of a campaign rally in which Trump has notoriously made targeted attacks against his enemies.
Trump spoke at length about the accomplishments his administration has made in regards to healthcare, bolstered by standing ovations and chants of “four more years” from the majority-white seniors in the deep-red area just outside of Orlando.
“In my campaign for president,” he said, “I made you a sacred pledge that I would strengthen, protect and defend Medicare for all of our seniors. 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 executive order
An executive order can be issued by the president as a way of bypassing both chambers of Congress. Since the House of Representatives is currently controlled by Democrats who are in the process of impeaching the president, it makes sense that he wished to bypass a House vote.
The executive order directs the Department of Health and Human Services (HHS) to make the following changes to Medicare Advantage:
- Expand plan options,
- Encourage innovative plan designs and payment models, and
- Improve and simplify the enrollment process.
Problems with the President’s push for Medicare Advantage
The executive order, in part, is intended to encourage more seniors to purchase Medicare Advantage plans sold by private insurance companies. And going into 2020, Medicare Advantage seems like a good choice for many seniors–plan options are up and premiums are down.
However, some Medicare Advantage plans have been caught defrauding Medicare and taxpayers to the tune of $10 billion annually. Additionally, private insurers are issuing $1.3 billion in rebates this fall as recompense for intentionally overcharging consumers. Instead of driving healthcare costs down, this could result in higher taxes for all Americans to offset the cost of untrustworthy private insurers.
Trump’s target: Medicare for All
The Trump speech consisted of very few policy details, but instead focused on Democrats pushing for Medicare for All.
“Leading Democrats have pledged to give free health care to illegal immigrants,” he said. “I will never allow these politicians to steal your health care and give it away to illegal aliens.”
Medicare for All is primarily promoted by 2020 presidential candidates Senators Bernie Sanders (I-VT) and Elizabeth Warren (D-MD). Other candidates in the race are overwhelmingly in favor of Medicare expansion, with lone wolves like former Vice President Joe Biden advocating to leave Medicare alone and improve the Affordable Care Act.
“Every major Democrat in Washington has backed a massive government health care takeover that would totally obliterate Medicare,” Trump said. “These Democratic policy proposals…may go by different names, whether it’s single payer or the so-called public option, but they’re all based on the totally same terrible idea: They want to raid Medicare to fund a thing called socialism.”
The speech’s conclusion
Near the end of the address, Trump listed several efforts his administration has made to lower drug prices. However, as none of these attempts have been successful, he suggested they have failed because pharmaceutical companies are colluding with House Democrats who are currently calling for his impeachment.
Alex Azar, Secretary of HHS, said in a press briefing on the Trump speech, this is “the most comprehensive vision for health care that I can recall any president putting forth.”
Azar also highlighted several actions the administration has taken to improve healthcare, including:
- Increasing price transparency,
- Ending the HIV epidemic, and
- Improving generic drug approval and availability.
Heading into the 2020 race, Trump is positioning himself as the sole protector of Medicare, a bold and potentially effective move due to regularly high senior voting turnout, and a fierce loyalty to Medicare for those who have it.