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Trump executive order to focus on modernizing Medicare

Rulemaking designed to contrast with Democrats’ ‘Medicare for All’

Executive order is expected to focus on increasing Medicare access to telehealth and innovative therapies. (Bill Clark/CQ Roll Call file photo)
Executive order is expected to focus on increasing Medicare access to telehealth and innovative therapies. (Bill Clark/CQ Roll Call file photo)

An executive order President Donald Trump will sign this afternoon will focus on modernizing Medicare by increasing access to telehealth and innovative therapies, according to senior officials.

The administration is also positioning the order as a contrast to Democratic presidential candidates campaigning on “Medicare for All” government-run health care, in part by strengthening private insurance plans that operate as part of the giant health program for seniors under the Medicare Advantage system. Seniors are a major voting bloc and health care is a significant part of the 2020 presidential campaign.

“While Democrats are focused on Medicare for All, which will ultimately deliver Medicare for none, the president is focused on protecting Medicare for our nation’s seniors,” Domestic Policy Council Director Joe Grogan told reporters. “He is delivering on his promise to lower costs, increase options, improve quality and give patients control over their health decisions.”

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The order will contain provisions aimed at modernizing Medicare coverage options, in part by including telehealth — which allows medical professionals to examine patients remotely — in requirements that insurance plans have an adequate number of doctors and other providers. The administration also will seek to strengthen options for innovative therapies that typically don’t fit under the program’s existing coverage and payment guidelines.

The order will also focus on reducing regulatory burden for providers, which is already a hallmark of the administration’s health care agenda. Centers for Medicare and Medicaid Services Administrator Seema Verma said prior authorization, which requires doctors to obtain permission from health plans for certain medications or treatments, is a top focus.

“Across the board, that’s one issue that has come up time and time again with providers,” Verma said.

The order will also contain directions to allow other types of clinicians, such as nurse practitioners and physician assistants, to practice at the top of their licenses, reducing supervision requirements for physicians. Doctors have opposed this idea, but Health and Human Services Secretary Alex Azar said the move is expected to help with rural practices that suffer the most from provider shortages.

The order also underscores the administration’s focus on the private insurance market by directing HHS to evaluate whether it promotes or incentivizes traditional Medicare over private insurance plans in Medicare Advantage. The administration has persistently touted the benefits of Medicare Advantage plans, which have more flexibility to offer benefits than traditional Medicare.

Azar will propose a rule under the order’s directives to expand plan diversity and affordability, he said. The order will also encourage innovative plan structures, such as including options for medical savings accounts and proposing a payment pilot to help patients share more in the savings achieved through supplemental benefits.

The administration has persistently touted the fact that Medicare Advantage and Part D premiums have declined under Trump’s tenure. The talking point is a major reason the administration killed a controversial rule on prescription drug rebates in July, which was projected to increase premiums as a result.

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