President Trump in Charlotte, North Carolina. Photo: Brian Blanco/Getty Images

President Trump outlined his ambitions for health care policy in a North Carolina speech Thursday, promising "the highest standard of care anywhere in the world," before signing an executive order guaranteeing protections for pre-existing conditions and then pledging to ban surprise medical bills.

Reality check: The only reason that pre-existing conditions protections, which are guaranteed under the Affordable Care Act, are at risk is because a Trump-backed lawsuit against the law is pending before the Supreme Court. Trump's executive order offers few details, and executive orders in and of themselves don't change policy. The order "simply declares it's national policy to protect coverage of people with preexisting conditions," Politico writes.

  • The Supreme Court is expected to hear the ACA case the week after the election.

Details: Trump's vision also directs Health and Human Services Secretary Alex Azar to work to pass legislation that would ban "surprise" medical bills, and boasts action to lower drug prices. This "would require legislation passed by Congress," the New York Times notes. The president has failed to enact any major prescription drug pricing reforms during his four years in office.

  • The directive is backed by a promise to "investigate executive actions and regulatory actions that we can take that will ensure that patients are nonetheless protected against surprise medical bills" should Congress fail to pass legislation by the start of 2021, Azar told reporters earlier Thursday.
  • Trump further announced he planned to mail $200 discount cards to Medicare beneficiaries to put toward prescription drug co-pays.
  • In a briefing call with reporters earlier in the day, White House aide Brooke Rollins promised that the administration "will continue to invest heavily in research and innovative treatments for complex health conditions."

Between the lines: The death of Justice Ruth Bader Ginsburg last week "raises the possibility Trump could add a conservative justice to the Supreme Court who could provide the decisive vote to strike down the health care law and throw the nation’s health system into disarray," Politico writes.

What he's saying: Trump painted the Democratic vision for health care as "a socialist nightmare" and touted his administration's efforts aimed at lowering drug prices and repealing the ACA's individual mandate.

  • "As we restore America to full strength, the first healthcare plan will be a core part of our national renewal," Trump said.

The other side: House Speaker Nancy Pelosi called the policy a “bogus executive order," adding, “If President Trump cared at all about people with pre-existing conditions, he would drop his lawsuit to overturn the Affordable Care Act in the middle of a pandemic," the Hill reports.

  • Joe Biden tweeted: 'They are arguing to strip millions of Americans of health care in the middle of a pandemic. We can't let him win."

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