President Trump travels to the Villages of Florida to announce Medicare executive order

President Trump will be in Florida Thursday, touting a new executive order entitled, “Protecting Medicare from Socialist Destruction.”  Though the president enjoys some support among the residents of the Villages retirement community where he will unveil the order, most seniors will wisely say, “Thanks, but no thanks.”

We’ll deal with the ‘Socialist Destruction’ canard a little later. But first… why would America’s seniors entrust their Medicare coverage to a president whose administration has worked so hard to undermine it since the day he took office?  Expecting Trump to protect Medicare is like trusting former House Speaker Paul Ryan to protect Medicaid.

Medicare Cuts

Despite candidate Trump’s promising older people “not to touch” their earned benefits, the president has proposed to slash Medicare by $846 billion over ten years, which would accelerate the insolvency of the Medicare trust fund.  So far, Congress has rejected these cuts, but if the President wins re-election, all bets are off.

“Republicans want Trump to deal with the exploding deficit by gutting the social safety net, and the president is reportedly receptive to the idea… President Trump has told friends that gutting Medicare could be a fun ‘second-term project.’” – Vanity Fair, 8/22/19

And that’s only the beginning.

Medicare Advantage Bias

Bloomberg reports that the President will use his Florida appearance to promote private Medicare Advantage (MA) plans.  This would be consistent with the administration’s unabashed advocacy for Medicare Advantage over traditional Medicare.

“From day one, President Trump and his administration have worked to provide seniors with high-quality, affordable care in the Medicare program and improved options through Medicare Advantage.” – White House spokesperson Judd Deere

But it isn’t the President’s job to shill for private plans while ignoring publicly-run traditional Medicare, which has provided seniors with quality health coverage for more than 50 years.  Medicare remains one of the most efficient health insurers in the nation, consistently spending less per patient than private insurance providers.

While Medicare Advantage may be a viable option for healthier seniors, it constricts patients’ choices of doctors and may not cover medical expenses incurred while traveling.  A healthy senior might not worry about the limited network of medical providers in Medicare Advantage, but a patient diagnosed with a chronic or serious condition like diabetes, heart disease, or cancer may find that her preferred specialists are not part of her private MA insurer’s system. If that patient switches to traditional Medicare, she may not be able to acquire a supplemental Medigap policy to cover copays and deductibles.

Meanwhile, Medicare Advantage plans are currently under fire from watchdog groups for overcharging for health care services, to the tune of billions of dollars.  

“Officials have known for years that some Medicare Advantage plans overbill the government by exaggerating how sick their patients are or by charging Medicare for treating serious medical conditions they cannot prove their patients have… Officials with the Centers for Medicare & Medicaid Services repeatedly have postponed or backed off efforts to crack down on billing abuses and mistakes.” – National Public Radio, 7/16/19

As we begin another open enrollment season, the Centers for Medicare and Medicaid Services’ (CMS) online tools once again may be skewed toward Medicare Advantage. That flies in the face of CMS claims that its goal is to be “a trusted and neutral resource for Medicare beneficiaries.”  As David Lipschutz of the Center for Medicare Advocacy noted:

“Unfortunately, CMS materials since the Fall of 2017 have not maintained such neutrality. Rather than presenting differences between traditional Medicare and private MA plans in an unbiased manner, CMS material has overplayed the pluses of MA and downplayed minuses in a manner that is highly misleading, at best.” – Center for Medicare Advocacy, 8/8/19

Debunking “Socialist Destruction”

Through word and deed, President Trump has betrayed his campaign promise to protect Medicare.  But in Florida it appears that the president, with his talk of “Socialist Destruction,” will take this effort to undermine the program to new Orwellian lows. In fact, Medicare has deep roots in American social policy dating to the early 20th century, an evolving belief that workers needed insurance against inevitable economic hardships – including sickness, disability, retirement, and loss of employment.

Before Medicare was enacted in 1965, conservatives including Ronald Reagan predicted that if the seniors’ health care program became law, Americans would one day find themselves “telling our children and our children’s children what it once was like in America when men were free.”

But President Lyndon B. Johnson, who signed Medicare into law, had it right when he said that Medicare “is the American way.  It is practical. It is sensible. It is fair. It is just.”

President Lyndon B. Johnson signs Medicare into law on June 30, 1965

President Lyndon B. Johnson signs Medicare into law on June 30, 1965

Fifty-four years later, there’s no doubt that Medicare needs improvements.  Democrats in Congress have proposed legislation to add dental, hearing, and vision coverage to traditional Medicare.  Speaker Pelosi has championed a bill to allow Medicare to negotiate prescription drug prices with Big Pharma, which could save patients and taxpayers billions of dollars per year.  The Affordable Care Act – which President Trump tried mightily to repeal and continues to undermine – extended Medicare’s solvency and provided beneficiaries with annual wellness screenings at no out-of-pocket cost to the patient.

The Trump administration and powerful special interests may want to see Medicare cut and privatized, but the public is solidly behind the program.  Polling indicates that majorities of voters across party lines oppose Medicare benefit cuts – including raising the eligibility age to 67 – and do not want to see the program privatized. The president can go Florida, pose as a champion for seniors’ health care, and rant about “Socialist Destruction,” but seniors know that the Trump administration and its allies in Congress constitute the most fundamental threat to Medicare today.