President Trump signed an executive order Thursday aimed at improving the Medicare program for seniors, hoping to redirect the 2020 campaign conversation from his failure to overhaul President Obama’s program to his step-by-step efforts to stamp out health crises and stiff-arm Democrats pushing government-run care.
Speaking in The Villages, Florida, a massive retirement community, the president renewed his 2016 pledge not to touch Medicare while in office.
“As long as I am president, no one will lay a hand on your Medicare benefits,” he told a crowd of people who rely on the federal insurance program for Americans 65 and older.
Officials said Mr. Trump’s order will increase seniors’ choices, help them access their health data and expand “telehealth” services that allow patients and doctors to interact from afar.
It promotes Medicare Advantage plans, which are run by private companies that contract with the government, by offering to let enrollees share in savings from better health outcomes. And it ensures that consumers aren’t steered into the traditional “fee-for-service” program over Medicare Advantage.
Mr. Trump mainly used his speech to contrast his broader approach with Democratic plans to expand coverage through ideas such as government-run “Medicare for All,” which his administration views as a “socialist” push to upend health plans that millions of people know and enjoy.
“These people on the other side, these people are crazy, by the way. They want to take it away, give you lousy healthcare,” Mr. Trump said in freewheeling remarks that touched on Supreme Court Justice Brett M. Kavanaugh, the 2020 Democratic primary and “open borders.”
Mr. Trump tried to find common ground with the senior crowd, saying retirement looks pretty good.
“I should be in this audience, clapping,” he said. “But I didn’t trust anybody to be standing here [at the podium], because I know what you have.”
Mr. Trump swept into office pledging to repeal Obamacare and replace it with a health plan that offered “insurance for everybody,” though his GOP allies were unable to send a bill to his desk in 2017.
The president settled for incremental changes. He expanded access to cheaper, bare-bones coverage and pushing Congress to zero out the “individual mandate” penalty for shirking insurance as part of congressional Republicans’ broad tax overhaul.
Mr. Trump says he would like to take another run at replacing the 2010 Affordable Care Act, though he is punting major decisions and votes until after the 2020 election.
“If the Republicans take back the House, keep the Senate, keep the presidency, we’re going to have a fantastic plan,” he said.
The administration has shifted its rhetoric away from Obamacare in recent months, favoring Mr. Trump’s push to tackle “surprise” medical billing, speed the approval of generic drugs and explore ways to safely import cheaper drugs from Canada.
Mr. Trump said he’s being so bold that health care lobbyists might be behind the Democrats’ impeachment bid.
“I would be very surprised if the hoax didn’t come a little bit from the people that we’re taking on,” he said. “I wouldn’t be surprised if it was from some of these industries that we take on, like pharma.”
Democrats are working with Mr. Trump on some of his health care efforts but say bigger action is needed.
Liberals pushing a single-payer system say their model will enhance the Medicare program for seniors while extending government-sponsored care to Americans of all ages, as millions continue to go uninsured or struggle with medical debt.
“Every single Medicare for All and public option proposal put forward by members of Congress would provide more Americans more health care — increasing the number of people with coverage, lowering out-of-pocket costs, and expanding benefits,” said Maura Calsyn, managing director of health policy at the Center for American Progress, a liberal think tank.
But Trump officials argue government-run programs would restrict choice, rob millions of people of private insurance and weaken a program that’s working for seniors.
Seema Verma, administrator of the Centers for Medicare and Medicaid Services, dubbed Mr. Trump “the great protector” of Medicare. She said proposals such as Medicare for All or a public option to compete with private plans are immoral and would “demote American seniors to little better than second-class status.”
Sensing the risky politics of single-payer, candidates such as former Vice President Joseph R. Biden are running on plans to patch up Obamacare and enhance it.
Mr. Trump is seizing on any vulnerability he can, however, pointing to some Democrats’ push to subsidize health coverage for immigrants who are in the U.S. illegally.
“They put them way ahead of American citizens like you, who obey our laws,” Mr. Trump told the Floridians.
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