Trump’s lie-filled Medicare for All op-ed

Trump’s lie-filled Medicare for All op-ed

››› ››› NICK FERNANDEZ

For some misguided reason, USA Today published an op-ed -- supposedly written by President Donald Trump -- attacking a proposed “Medicare for All” plan cosponsored by a number of Senate Democrats. The piece is a collection of baldfaced lies and distorted facts which do not hold up to even the slightest scrutiny.


Sarah Wasko / Media Matters

USA Today allowed Trump to publish lie-riddled op-ed claiming Democrats support “government-run” health care. USA Today published an op-ed allegedly written by President Donald Trump attacking a proposed “Medicare for All” health care plan that 16 Democratic senators have cosponsored. The op-ed is filled with blatantly false claims about what a Medicare for all system would actually do and concludes with a screed denouncing “open-borders socialism.” From the October 10 op-ed:

Throughout the year, we have seen Democrats across the country uniting around a new legislative proposal that would end Medicare as we know it and take away benefits that seniors have paid for their entire lives.

Dishonestly called “Medicare for All,” the Democratic proposal would establish a government-run, single-payer health care system that eliminates all private and employer-based health care plans and would cost an astonishing $32.6 trillion during its first 10 years.

As a candidate, I promised that we would protect coverage for patients with pre-existing conditions and create new health care insurance options that would lower premiums. I have kept that promise, and we are now seeing health insurance premiums coming down.

The Democrats' plan means that after a life of hard work and sacrifice, seniors would no longer be able to depend on the benefits they were promised. By eliminating Medicare as a program for seniors, and outlawing the ability of Americans to enroll in private and employer-based plans, the Democratic plan would inevitably lead to the massive rationing of health care. Doctors and hospitals would be put out of business. Seniors would lose access to their favorite doctors. There would be long wait lines for appointments and procedures. Previously covered care would effectively be denied.

In practice, the Democratic Party’s so-called Medicare for All would really be Medicare for None. Under the Democrats' plan, today’s Medicare would be forced to die. [USA Today, 10/10/18]

But Trump’s op-ed includes out-and-out lies and distorted facts about the Senate’s proposed “Medicare for All” plan

Claim: “The Democratic proposal would establish a government-run, single-payer health care system … and would cost an astonishing $32.6 trillion during its first 10 years.”

Dishonestly called ‘Medicare for All,’ the Democratic proposal would establish a government-run, single-payer health care system that eliminates all private and employer-based health care plans and would cost an astonishing $32.6 trillion during its first 10 years. [USA Today, 10/10/18]

Reality: While federal spending would increase, overall health care spending would actually be reduced.

Vox: “The federal government is going to spend a lot more money on health care, but the country is going to spend about the same.” From Vox’s July 30 article:

It sure sounds like a lot of money, and conservatives hopped all over the figure on Monday morning. But there are a lot of ways to think about $32 trillion — and one might be that it’s actually kind of a bargain.

Mercatus is projecting a $32 trillion increase in federal spending, above current projected government expenditures, from 2022 to 2031.

In terms of overall health care spending in the United States over the same period, however, they are actually projecting a slight reduction.

There is the rub. The federal government is going to spend a lot more money on health care, but the country is going to spend about the same.

When you consider a universal single-payer program would 1) cover every single American, eliminating uninsurance and 2) provide much more robust benefits, covering more services than get covered right now, then it starts to look like a good deal.

More people covered. More services covered. Same price, more or less. [Vox, 7/30/18]

Claim: “I promised that we would protect coverage for patients with pre-existing conditions and create new health care insurance options that would lower premiums. I have kept that promise.”

As a candidate, I promised that we would protect coverage for patients with pre-existing conditions and create new health care insurance options that would lower premiums. I have kept that promise, and we are now seeing health insurance premiums coming down. [USA Today, 10/10/18]

Reality: False. Insurance companies “are requesting large premium increases for 2019” as a result of the Trump administration’s actions, and the White House has actively sought to undermine access to affordable insurance for those with pre-existing conditions.

Center for American Progress: Trump administration’s repeal of the Affordable Care Act’s individual mandate “and short-term plans are driving up premiums.” From the Center for American Progress’s July 24 article:

The individual mandate was one of the ACA’s mechanisms for keeping premiums low by stabilizing the insurance risk pool. Congressional Republicans’ tax bill—backed by the Trump administration—effectively eliminated the individual mandate starting in 2019. As a result, experts predict that young, healthy enrollees will tend to forgo health insurance, which leads to a sicker individual market risk pool and higher premiums for remaining enrollees. The nonpartisan Congressional Budget Office (CBO) has projected that mandate repeal will drive insurers to raise rates an additional 10 percent. What’s more, the Trump administration has made regulatory changes to widen the availability of short-term plans that offer substandard coverage, harming the ACA risk pool and raising rates for comprehensive coverage.

Rate filings to date show that many insurers are requesting large premium increases for 2019. The average requested rate increase was 30.2 percent in Maryland and 24 percent in New York state. Most insurers have specifically cited the repeal of the individual mandate in their actuarial memorandums. In New York, insurers attributed about half their large requested increases to mandate repeal. Even in states with small rate increases or overall decreases, insurer filings state that premiums next year would be significantly lower in the absence of federal sabotage. [Center for American Progress, 7/24/18]

LA Times: The Trump Justice Department has endorsed a lawsuit that would remove the Affordable Care Act’s “protections for people with preexisting conditions.” From the Los Angeles Times’ June 8 article:

In its latest effort to undermine the Affordable Care Act — and in the process, raise premiums for many Americans — the Trump administration is urging a federal judge in Texas to throw out the law’s protections for people with preexisting conditions.

Its latest gambit came Thursday, when the Justice Department partially endorsed Texas’ latest lawsuit against the ACA. The lawsuit focuses on the Supreme Court’s decision in 2012 that upheld the ACA’s requirement that adult Americans carry insurance or pay a tax penalty, saying it was a valid exercise of Congress’ power to tax. Noting that the GOP tax cuts that President Trump signed into law in December eliminated that tax penalty, the lawsuit argues that the law has been rendered unconstitutional.

The Justice Department’s brief asserts that the mandate to buy insurance is indeed unconstitutional now. That’s no big deal — with no penalty, there’s really no mandate. What is a big deal is the department’s contention that because the mandate is gone, the court must throw out the ACA’s two main protections for people with preexisting conditions: the requirements that insurers accept all applicants (“guaranteed issue”) and that they charge people with preexisting conditions no more than healthy people in the region (“community rating”).

“Congress found that enforcing guaranteed issue and community-rating requirements without an individual mandate would allow individuals to game the system by waiting until they were sick to purchase health insurance, thereby increasing the price of insurance for everyone else — the polar opposite of what Congress sought in enacting the ACA,” the department’s brief argues.

That’s some legal jiujitsu right there. The Justice Department is taking the argument of why an individual mandate was an essential part of the ACA’s insurance reforms, and using it to take down those reforms now that the mandate has been snuffed by Congress. Not that the administration is wrong about what will happen now that the mandate has been killed — what’s wrong is arguing that the havoc Republicans wreaked upon the individual market justifies doing even more harm to the people in it. [Los Angeles Times, 6/8/18]

Claim: “I am fighting so hard against the Democrats' plan that would eviscerate Medicare.”

I also made a solemn promise to our great seniors to protect Medicare. That is why I am fighting so hard against the Democrats' plan that would eviscerate Medicare. [USA Today, 10/10/18]

Reality: Under the Trump administration, Republicans have sought to slash various entitlement programs, including Medicare.

Wash. Post: House Republicans proposed “large cuts to entitlement programs, including Medicare, that President Trump vowed not to touch.” From The Washington Post’s June 19 article:

House Republicans released a proposal Tuesday that would balance the budget in nine years — but only by making large cuts to entitlement programs, including Medicare, that President Trump vowed not to touch.

The House Republican budget, titled “A Brighter American Future,” would remake Medicare by giving seniors the option of enrolling in private plans that compete with traditional Medicare, a system of competition designed to keep costs down but dismissed by critics as an effort to privatize the program. Along with other changes, the budget proposes to squeeze $537 billion out of Medicare over the next decade. [The Washington Post, 6/19/18]

Claim: “Democrats have already harmed seniors by slashing Medicare by more than $800 billion over 10 years to pay for Obamacare.”

Democrats have already harmed seniors by slashing Medicare by more than $800 billion over 10 years to pay for Obamacare. Likewise, Democrats would gut Medicare with their planned government takeover of American health care. [USA Today, 10/10/18]

Reality: This is a blatant lie that has been around since 2012 and refuses to die.

Wash. Post: “The anticipated savings from Medicare” as a result of the Affordable Care Act “were used to help offset some of the anticipated costs of expanding health care for all Americans, they did not affect the Medicare trust fund.” From The Washington Post’s August 4 article:

Regular readers may recall that Republicans, in the 2012 presidential election campaign, charged that the Affordable Care Act, a.k.a Obamacare, would cut Medicare by $700 billion. We wrote about this issue repeatedly during the 2012 campaign and again when it reemerged briefly in the 2014 elections.

While the anticipated savings from Medicare were used to help offset some of the anticipated costs of expanding health care for all Americans, they did not affect the Medicare trust fund. The Obama health-care law also raised Medicare payroll taxes by $318 billion over the 10-year time frame, further strengthening the program’s financial condition.

The Medicare reductions in the ACA are the law of the land. In fact, Republicans in Congress and the Trump administration in their budget plans have pocketed virtually all of those savings — and sought even more reductions in Medicare spending on top of that. [The Washington Post, 8/4/18]

Claim: “The Democratic plan would inevitably lead to the massive rationing of health care.”

By eliminating Medicare as a program for seniors, and outlawing the ability of Americans to enroll in private and employer-based plans, the Democratic plan would inevitably lead to the massive rationing of health care. [USA Today, 10/10/18]

Reality: As its name suggests, Medicare for all would not “eliminate Medicare as a program for seniors,” and “rationing” is a fearmongering term to describe “parameters for what services” Medicare may or may not cover.

The proposed Senate plan would make it unlawful for “a private health insurer to sell health insurance coverage that duplicates the benefits provided under” the proposed bill. From the proposed Medicare for All Act of 2017 (emphasis added):

SEC. 107. PROHIBITION AGAINST DUPLICATING COVERAGE.
(a) In General.—Beginning on the effective date described in section 106(a), it shall be unlawful for—

(1) a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act; or

(2) an employer to provide benefits for an employee, former employee, or the dependents of an employee or former employee that duplicate the benefits provided under this Act.

(b) Construction.—Nothing in this Act shall be construed as prohibiting the sale of health insurance coverage for any additional benefits not covered by this Act, including additional benefits that an employer may provide to employees or their dependents, or to former employees or their dependents. [S.1804, Medicare for All Act of 2017, 9/13/17]

Vox: Most single-payer health care systems “foot the entire bill for a core set of benefits,” and often individuals can purchase supplemental private insurance to cover additional, non-core services. Additionally, as Vox points out, “Supporters of single-payer systems tend to point out that the United States employs a different kind of rationing: people who can’t afford health insurance often don’t get it. That means these people never get access to health-care treatments regardless of whether it might help. These people are effectively waiting forever, and that won’t show up on surveys about wait times.” [Vox, 5/31/15, 5/31/15]

Claim: “Doctors and hospitals would be put out of business.”

Reality: Doctors and hospitals “may have to take pay cuts,” but the expansion of Medicare “coverage means that hospitals and doctors would no longer need to worry about unpaid bills from patients who lack insurance or can’t afford to pay their insurance deductible.”

NY Times: Medicare expansion “may also save on administrative costs, since they would not need to interact with as many insurers or to bill patients for services.” From The New York Times’ September 14, 2017, article:

Doctors and hospitals may have to take pay cuts, since the current Medicare program typically pays them less than commercial insurers pay for the same services.

But the bill’s expansion of coverage means that hospitals and doctors would no longer need to worry about unpaid bills from patients who lack insurance or can’t afford to pay their insurance deductible. They may also save on administrative costs, since they would not need to interact with as many insurers or to bill patients for services.

The bill does not specify exactly what doctors and hospitals would be paid, and the effects would depend on those details. But decreases and changes in payment policy could cause changes to the business of health care as hospitals, doctors, nurses and others adjust to lower payment rates and salaries.

Universal Medicare-like payment rates would almost certainly cause some major disruptions, like hospital closings. [The New York Times, 9/14/17]

Polling shows consistent support for some form of a single payer system, even among American doctors. According to various surveys, American doctors are embracing some version of a single-payer system. In August 2017, according to Forbes, “More than half of U.S. physicians support a single payer healthcare system with 42% ‘strongly’ in favor.” This March, a NEJM Catalyst survey of clinicians found that “61 percent of 607 respondents said single-payer would make it easier to deliver cost-effective, quality health care.” [Forbes, 8/13/17; Kaiser Health News, 8/7/18]

Claim: “Seniors would lose access to their favorite doctors.”

Reality: No way to know for sure, but, logically, probably untrue.

If a Medicare for all system is implemented, it would theoretically do away with many current insurance networks. Medicare would presumably be accepted by most doctors except for the specialized care such as cosmetic surgery, which would be covered by supplemental private insurance.

Claim: “There would be long wait lines for appointments and procedures.”

Reality: This is nonsense. While some countries with single-payer systems, such as Canada, have wait times for certain non-urgent procedures, “most research doesn’t suggest any particular relationship between the financing model and how tough it is to see a doctor.”

According to Physicians for a National Health Program, “Wait times are a function of a health system’s capacity and its ability to monitor and manage patient flow,” and, according to Vox, “data suggests that that long wait times are not systemic to single-payer systems.” [Physicians for a National Health Program, accessed 10/10/18; Vox, 5/31/15]

Claim: “Previously covered care would effectively be denied.”

Reality: This doesn’t make sense.

The Medicare for All Act of 2017 clearly states, “Nothing in this Act shall be construed as prohibiting the sale of health insurance coverage for any additional benefits not covered by this Act.” The law would provide coverage for a core set of benefits, and any services that are not covered can be covered by supplemental private insurance. [S.1804, Medicare for All Act of 2017, 9/13/17]

Claim: “The Democratic Party’s so-called Medicare for All would really be Medicare for None.”

In practice, the Democratic Party’s so-called Medicare for All would really be Medicare for None. Under the Democrats' plan, today’s Medicare would be forced to die. [USA Today, 10/10/18]

Reality: Again, this doesn’t make sense for various reasons already explained above.

Claim: “The first thing the Democratic plan will do to end choice for seniors is eliminate Medicare Advantage plans.”

The first thing the Democratic plan will do to end choice for seniors is eliminate Medicare Advantage plans for about 20 million seniors as well as eliminate other private health plans that seniors currently use to supplement their Medicare coverage. [USA Today, 10/10/18]

Reality: If a Medicare Advantage plan “duplicates the benefits provided under” the proposed Medicare for All Act of 2017, then it would be done away with to protect patients from being billed for publicly funded services already provided to them for free at the point of care.

The Medicare for All Act of 2017 clearly states, “Nothing in this Act shall be construed as prohibiting the sale of health insurance coverage for any additional benefits not covered by this Act.” The Medicare for All Act of 2017 would provide coverage for a core set of benefits, and any services that are not covered can be covered by supplemental private insurance. [S.1804, Medicare for All Act of 2017, 9/13/17]

Claim: “The Democrats would eliminate every American’s private and employer-based health plan.”

Next, the Democrats would eliminate every American’s private and employer-based health plan. It is right there in their proposed legislation: Democrats outlaw private health plans that offer the same benefits as the government plan. [USA Today, 10/10/18]

Reality: It is indeed “right there in their proposed legislation,” but the plan wouldn’t leave individuals without coverage.

The Medicare for All Act of 2017 clearly states, “Nothing in this Act shall be construed as prohibiting the sale of health insurance coverage for any additional benefits not covered by this Act.” The law would provide coverage for a core set of benefits, and any services that are not covered can be covered by supplemental private insurance. [S.1804, Medicare for All Act of 2017, 9/13/17]

Claim: “Virtually everywhere it has been tried, socialism has brought suffering, misery and decay.”

Reality: Single-payer health care systems ≠ “socialism.”

Here’s how the difference between single-payer and “socialized medicine” is explained by Physicians for a National Health Program:

In socialized medicine systems, hospitals are owned by the government and doctors are salaried public employees. Although socialized medicine has worked well for our Veterans Administration, and for countries that have single-payer “national health services” like England, Sweden and Spain, that way of organizing care is not the same as what we are talking about here.

Canada is often cited as an example of a country with single-payer health insurance. Canada’s federal and provincial governments handle the system’s financing, but care is delivered mainly through doctors in private practice and privately owned hospitals.

In many ways our traditional Medicare program, which is a form of social insurance, bears a resemblance to single-payer national health insurance. [Physicians for a National Health Program, accessed 10/10/18]

Claim: “Millions more would cross our borders illegally and take advantage of health care paid for by American taxpayers.”

Indeed, the Democrats' commitment to government-run health care is all the more menacing to our seniors and our economy when paired with some Democrats' absolute commitment to end enforcement of our immigration laws by abolishing Immigration and Customs Enforcement. That means millions more would cross our borders illegally and take advantage of health care paid for by American taxpayers. [USA Today, 10/10/18]

Reality: The Medicare for All Act of 2017 defines eligible individuals as an “individual who is a resident of the United States,” and “only allows ‘an alien lawfully admitted for permanent residence’ to buy into” the proposed system.

ThinkProgress: “The transition to the single-payer system only allows ‘an alien lawfully admitted for permanent residence’ to buy into Medicare,” and the White House would have discretion for which immigrants qualify. From ThinkProgress’s September 14, 2017 article:

The transition to the single-payer system only allows “an alien lawfully admitted for permanent residence” to buy into Medicare, as under the ACA. But once single-payer is fully implemented, the discretion of which immigrant qualifies is ultimately left to the White House, leaving the fate of every immigrants’ care in the hands of whoever is president. [ThinkProgress, 9/14/17]

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