Trump’s Health Care Plan: Not Really A Plan At All

Last week, President Donald Trump signed an executive order on Medicare protections. And while it lists a lot of problems to alleviate and goals to achieve, it lays out few ways to get there — instead creating a review period to figure out how to get there.

Like nearly all of his campaign and presidential efforts, this executive order is not about what he will try to do, or what his administration stands for. Instead, it focuses on what he is against and what his political opponents are fighting for.

Most of the order is focused on improving transparency, generating more options for plans and securing funding for Medicare and Medicare Advantage.

The executive order, which was originally planned for the summer, was initially to be named “Protecting Medicare From Socialist Destruction” but was changed to “Protecting and Improving Medicare for Our Nation’s Seniors.”

Despite the change, the first working title would have been fitting, given that nearly the entire ‘purpose’ section of the executive order addresses that Trump’s plan is not socialism, nor is it Medicare for All.

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Pushed Back

CNN reported that the White House had originally planned to start releasing these health care orders in the summer, but that aides said, “mass shootings, travel and other events have scrambled those plans.” As a result, the plans are just now being released, putting them on a tight schedule to get a health care vision laid out by the time their Democratic opponent is decided.

There could also be some other factors in play with the timing of the release. As the summer progressed, a Trump Administration-backed lawsuit made its way through the court system. If that lawsuit were to be ‘successful’ (from Trump’s political point-of-view), it would have torn down the ACA.

With that, making changes to the health care system wouldn’t have made a ton of sense for the President actively trying to repeal the health care framing in place.

But now, with an impeachment inquiry underway, Trump’s team is releasing their health care plans now, by way of executive orders.

What It Says

President Trump’s twelve-section executive order includes nine ‘policy points.’ The main goals of the document are to, “protect and improve the Medicare program by enhancing its fiscal sustainability through alternative payment methodologies that link payment to value, increase choice, and lower regulatory burdens imposed upon providers,” the order reads.

The order lays out subsequent plans to work toward these goals. There are pieces that are aimed at increasing choice of plans for seniors, improving access through networks, enabling providers to spend more time with patients, encouraging innovation, “maximizing freedom,” reducing obstacles, eliminating waste and fraud, and so on.

The most important thing to note is that none of this is actually policy in place, or anything close. Rather, this is a plan laid out to give the White House time to figure out what to do.

Each of the “policy” pieces in the executive order holds a timeframe for actually deciding how to achieve the plans in the order. For most pieces, there is a “review period” of 180 days, for the Secretary of Health and Human Services to “revise current rules or policies.”

Each piece also says something like, “Within 1 year of the date of this order, the Secretary shall propose a regulation that would,” address whatever problem was superscribed.

So, the executive order isn’t really a policy rollout at all. It’s more of an executive order to perform legal review on the health care industry to figure out what could be done about problems plaguing the system now.


by Josh Cook
Posted 10/10/19

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