Trump Orders Worthy Improvements in Medicare

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Take note: Medicare open enrollment began last week and continues through Dec. 7. It’s an opportunity for seniors to ask what they want out of Medicare and choose an option moving them toward that goal. But those options could change significantly in the near future, for the better — or for the worse.

Let’s start with the worse: Medicare for All.

“M4A” as proposed by Democratic presidential candidates Bernie Sanders and Elizabeth Warren doesn’t actually expand Medicare to everyone. It ends Medicare as we know it and replaces it with a single-payer health-care system. To put it bluntly, if you like your Medicare plan, you will not be able to keep it.

Several other Democrats are backing a type of buy-in to the Medicare program, which they sometimes refer to as “Medicare for More.” Under most of those plans Medicare itself wouldn’t change. It would just allow people under the age of 65 to buy into Medicare or Medicare Advantage, thus establishing the left’s long-sought “public option.”

President Donald Trump is taking a different approach. He issued an executive order on Oct. 3 criticizing M4A proposals and requiring the Department of Health and Human Services to explore ways to create the Medicare options seniors want.

“Medicare for All would not only hurt America’s seniors, it would also eliminate health choices for all Americans,” the president said. “Instead of picking the health insurance that best meets their needs, Americans would generally be subject to a single, government-run system. Private insurance for traditional health services, upon which millions of Americans depend, would be prohibited. States would be hindered from offering the types of insurance that work best for their citizens. The secretary of Health and Human Services would have the authority to control and approve health expenditures. Such a system could create, among other problems, delays for patients in receiving needed care. To pay for this system, the federal government would compel Americans to pay more in taxes. No one — neither seniors nor any American — would have the same options to choose their health coverage as they do now.

Most of the president’s proposed changes require Department of Health and Human Services review and won’t be available for at least a year, which, probably not coincidentally, tees them up right before the November election. In addition, Medicare Administrator Seema Verma recently announced new flexibilities in Medicare Advantage plans that insurers are immediately incorporating.

AARP reports: “For example, someone with diabetes could get transportation to a doctor’s appointment, to a diabetes education program or to a meeting with a nutritionist. MA plans can even pay for cooking classes as part of improving someone’s diet. For someone with heart disease, an MA plan could provide heart-healthy produce or other food. If you have asthma, the plan could cover home air cleaners or even pay to shampoo a member’s carpet to remove the irritants that often trigger asthma attacks.”

According to the Roper Center, 52 percent of seniors voted for Trump in 2016 vs. 45 percent for Clinton. If it appears that M4A will take away their Medicare — and it will — we’re likely to see that percentage grow in 2020. Improving Medicare is probably a winning political issue; imploding it is not.

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