What Does a Trump Administration Mean For Medicare?

About 57 million Americans currently rely on Medicare for their access to health care. That’s quite a constituency – and no matter who won the election, the winner would have to confront some difficult questions concerning balancing the interests of current beneficiaries against the future solvency of the program. That said, if you are currently enrolled, or just about to enroll, your Medicare benefits are likely to be just fine. Let’s talk Trump and Medicare.

The Trump Administration

Donald Trump’s health care focus, at least for the first term, is likely to concentrate on the repeal and/or replacement of the Affordable Care Act, which won’t directly affect your Medicare benefits.

During the campaign season, the Trump team did not roll out any major Medicare initiatives whatsoever, basically stating that he didn’t want to “meddle with Medicare.” However, since winning the election, Trump has publicly pledged to “modernize Medicare, so that it will be ready for the challenges with the coming retirement of the Baby Boom generation – and beyond.” However, we still don’t have much in the way of specifics from the Trump administration as to precisely how he would accomplish that. Modernizing Medicare and leaving Medicare alone seem to be conflicting goals. At the executive level, there’s certainly room for improvements in technology, communication and access. These improvements can be made without the direct involvement of Congress.

Congressional Plans

Meanwhile, the House Republican majority led by Speaker Paul Ryan (R-Wisc.) has been busy putting together a more detailed policy position on health care, which was released over the summer. Among the paper’s key policy goals: Protecting and preserving Medicare.

Ryan and his team have proposed the following measures:

• Strengthen Medicare Advantage, also known as Part C.
• Allowing Medicare Advantage enrollees to switch to a different MA plan within the first three months of enrollment, for specific reasons.
• Combining Medicare Parts A and B, beginning in the year 2020, and apply a combined deductible for both plans.
• Gradually increase the Medicare retirement age to correspond with Social Security by the year 2020.

Again, you who are currently enrolled or who are enrolling within the next several years will likely face no significant changes to your benefits. The most detailed policy proposals envision changes beginning in 2024, when the House Republicans propose rolling out a series of private plans to compete with Medicare, under the “premium support” concept.

Ryan’s preferred strategy, called “premium support,” would change Medicare from a single payer system in which the government pays directly for seniors’ health care to one where beneficiaries could use their government benefits to buy private insurance.

Supporters say it would inject much-needed competition into the health care space, which would lead to lower costs and better coverage.

Critics respond that this would end Medicare as we know it- and instead of being able to count on basic health care after age 65, seniors would be forced to navigate a maze of insurance options, like Obamacare customers today. Well guess what? As it stands now, there is a maze of insurance options to choose from! You have thousands of Medicare Advantage plans across the country, as well as 11 “Standardized” Medicare Supplement insurance plans. Take it from someone who has these conversations daily with people new to Medicare, their heads are spinning. Critics also argue that Medicare is less expensive than private insurance and that seniors would receive substandard care under a premium support system.

Typically, premium support proposals would only affect services covered under Medicare Parts A and B, but not Medicare Part D. Lastly, the reform wouldn’t apply to anyone currently aged 55 or older.

Expanding Access to Physicians

That said, Medicare beneficiaries are already facing difficulties in finding physicians willing to take new Medicare patients. Doctors are facing low reimbursement rates and significant administrative hurdles when it comes to getting paid for services rendered.

The Trump nominee for Secretary of Health and Human Services, Rep. Tom Price (R-Ga.) is a former orthopedic surgeon himself, and he may have the credibility to work with Congress and the physician community to bring more doctors and health care providers back to providing Medicare services.

Naturally, we’re still very early in the process. Democrats in Congress will likely oppose many of these reforms. The final form any legislative compromise will take is anybody’s guess.

One thing I can promise you is that Lifelong Insurance will be with our clients through any changes that come down the pike. Actually, it’s a great idea to review your insurance coverage at least every year – including your Medicare, Medigap and Medicare Advantage coverage, to ensure you are getting the best protection possible at the best possible premium.