Oct 11, 2018 - Health

Reality check: Trump's "Medicare for All" op-ed

Donald Trump

Photo: Saul Loeb/AFP/Getty Images

Let’s be clear up front: Everything in health policy comes with a trade-off, including “Medicare for All,” no matter how you define it. Those costs very well may be more than American voters ultimately want to accept.

But President Trump did not lay out those choices particularly well in his USA Today op-ed yesterday.

Here's some of what he wrote...

“Under the Democrats' plan, today’s Medicare would be forced to die.”

Reality check: This has become a common refrain — that Medicare and “Medicare for All” are mutually exclusive. They’re not. You could keep the existing program intact and expand government coverage elsewhere — you’d just have to find a way to pay for it.

“The Democratic proposal … would cost an astonishing $32.6 trillion during its first 10 years.”

Reality check: This is an accurate summation, if we're taking "Medicare for All" to mean Sen. Bernie Sanders' plan. (There are others.)

  • But it's worth noting that we’re expected to spend roughly the same amount under the status quo.
  • The difference is how we spend it — in taxes, or in the existing hybrid of taxes, premiums and out-of-pocket costs.
“As a candidate, I promised that we would protect coverage for patients with pre-existing conditions … I have kept that promise.”

Reality check: The Trump administration is currently arguing in court that the ACA’s protections for pre-existing conditions should be struck down. It has no replacement plan. It also supported ACA repeal, which would have eroded many of those protections.

Between the lines: This is a campaign document, designed to fire up and turn out Republican voters, and it's a preview of what's to come as "Medicare for All" enters the political mainstream in 2020.

  • Some of these arguments are drawn from the anti-ACA playbook. But this time, a "government takeover of health care" is actually on the table (Sanders' bill would ban private insurance), so expect to hear this and more not only from Republicans, but also the entire health care industry.
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