During a signing ceremony that had the aura of a campaign rally, President Donald Trump to "strengthen, defend, and protect Medicare for all of our senior citizens," at a retirement community in Sumter County, Florida, on Thursday afternoon.
"As long as I'm president, no one will lay a hand on your Medicare benefits," Trump said.
The president said his order would help Medicare beneficiaries access the "latest and greatest medical devices and therapies," reduce unnecessary regulations -- freeing up doctors and nurses to spend more time with patients and less time on paperwork -- and protect seniors from fraud and abuse.
"I'm directing Secretary Azar to crack down on criminal cheaters and dishonest providers who rob Medicare of the funds you have and the money that you paid into the system all of your lives," Trump said.
He also spoke about plans to lower drug prices through importing drugs from Canada and other counties.
"In a little while ... your governor is going to be able to go out and negotiate to his heart's content ... I have a feeling when that happens the drug companies are just going to say 'we can't have this.' And they're going to drop their price."
Trump also suggested that drugmakers might in fact be involved in "the hoax," referring to congressional investigations into the administration's contacts with Ukrainian leaders and the ongoing impeachment inquiry.
"They're very powerful, spend a lot of money... I wouldn't be surprised if some of the nonsense that ... I go through, I wouldn't be surprised if it was some of these industries, like pharmaceuticals, that we take on."
Details of the Executive Order
In a press call Thursday morning, Health and Human Services administration officials shared similar concerns regarding what they view as the Democratic threat to America's and particularly seniors' healthcare.
HHS Secretary Alex Azar explained that the new order would direct him to propose and to implement a rule to grow the Medicare Advantage, and provide "more diverse and affordable plan options." The order gives the secretary 1 year to propose regulations to that end.
The new rule would encourage innovation in Medicare Advantage structures and plan designs, reduce barriers to accessing Medicare medical savings accounts, and promote "innovations and supplemental benefits and telehealth services," Azar said.
"We would have to include a payment model through our Center for Medicare and Medicaid Innovation that adjusts supplemental Medicare Advantage benefits to allow Medicare beneficiaries to actually share more directly in the savings from the program, including through cash or monetary rebates, which would create more incentives for them to seek high-value care."
Lastly, the rule would look to ensure that the fee-for-service Medicare program isn't given advantages over Medicare Advantage, he added, "that we're not steering people into fee-for-service, as opposed to giving them a genuine choice of Medicare Advantage or fee-for-service."
The administration would achieve this last goal by examining the enrollment process to see if adequate information on Medicare Advantage plans has been offered through "various plan-finder tools" and "make sure there's no financial disincentive" to Medicare Advantage versus fee-for-service, Azar said.
As is typical of executive orders, the plan issued by the White House didn't include specifics, but rather left it to HHS to flesh out the details in the coming months. The order also didn't mention funding for programs likely to cost money, such as stepped-up efforts to attack that perennial bugbear of politicians: waste, fraud, and abuse.
The 'Same, Terrible Idea'
Trump's remarks about the executive order were the shortest part of his speech. He spent most of it ridiculing Democratic presidential candidates and their healthcare proposals.
He said "people on the other side" want to steal seniors' healthcare and replace it with something "lousy."
"These Democrat policy proposals may go by different names ... whether it's single-payer or the so-called public option, but they're all based on the totally same, terrible idea: They want to raid Medicare to fund a thing called socialism," Trump said.
"Every one of these plans involves rationing care, restricting access, denying coverage, slashing quality, and massively raising taxes," he said.
He called out one Democratic healthcare plan in particular -- Sen. Bernie Sanders' (I-Vt.) , estimated to cost $32 trillion over 10 years, "and reduce Americans household income by $17,000 per year."
Democrats' plans would funnel all Americans into a "single, socialist, government-run program" and eliminate private insurance for over 180 million Americans, including the 24 million seniors who have Medicare Advantage plans. It would "put doctors and hospitals out of business" and deny access to treatment, Trump said.
He cited 117-day waits for elective knee replacements in the U.K. and 9-months wait for elective orthopedic surgeries in Canada as further examples of access issues in countries with government-run healthcare systems. Wait times for similar surgeries in the U.S. are less than 2 weeks, Trump asserted.
He then brought in concerns over "open borders," referring to some Democrats' plans to give undocumented immigrants health insurance.
"I will never allow these politicians to steal your healthcare and give it away to illegal aliens," the president said.