Trump issues executive order to expand private Medicare insurance plans
President Donald J. Trump signed an executive order that directs HHS to take action to provide more insurance plan options under Medicare Advantage and to remove regulations that are burdensome to health care providers.
“This order is the latest step in my administration’s drive to ensure the world’s best health care for all Americans,” Trump said during the announcement. “Together, we’re creating a health care system that protects vulnerable patients, makes health care more affordable, gives you more choice and control, and delivers the high-quality care Americans deserve.”
The announcement comes as a response to the proposed Medicare for All Act of 2019. The act, according to Congress’ website, would establish a national health insurance program under HHS that would prohibit cost-sharing and provide medical benefits including hospital services, prescription drugs, dental and vision services and long-term care.
The executive order states that Medicare for All would be harmful to older adults in the United States and would eliminate health care choices for all Americans.
The executive order seeks to “protect and improve” the Medicare program for seniors and calls for HHS to take action to create policies that will:
- Provide more plan choices for Medicare Advantage beneficiaries, including plans that allow for Medicare savings accounts and promote telehealth services;
- Enable providers to spend more time with patients by remove regulatory burdens, including billing requirements, conditions to participate in the program and supervision requirements;
- Shift Medicare reimbursement to be based on time spent with patients, rather than procedures performed;
- Move for reimbursement for services based on work performed by nurse practitioners, physician assistants and physicians rather than the occupation;
- Encourage innovation through regulations that streamline the approval process of medical devices and telehealth services; and
- Seek to eliminate waste, fraud and abuse within the Medicare program.
With the removal of supervision requirements in the Medicare program, nonphysician clinicians, such as nurse practitioners and physician assistants, would be able to practice without being supervised by a physician.
David Herbert, JD, CEO of the American Association of Nurse Practitioners, told Healio Primary Care that for nurse practitioners “the general direction is a very positive one.”
He noted that the removal of requirements, such as those that require nurse practitioners to have a physician sign off on an order for home health, will help remove unnecessary costs to the health care system. The removal of these requirements will especially help relieve burden in rural or underserved communities where there are fewer physicians to sign off on such orders.
In a statement, the ACP said that although it supports some aspects of the order, especially those reducing administrative burdens to physicians and patients, it has concerns about many other parts of the order.
The organization expressed concern that the proposal to allow non-physicians clinicians to practice outside of a patient’s care team “could sever the patient-physician relationship and undermine coordinated, high-quality care,” and instead asked the administration to make efforts to encourage “innovative payment and delivery system models that emphasize teamwork, coordination, and value.”
The ACP also explained that their policy emphasizes that government efforts to improve Medicare “should not favor or give competitive advantage to [Medicare Advantage] plans over traditional Medicare.”– by Erin Michael
Congress.gov. H.R.1384 - Medicare for All Act of 2019. https://www.congress.gov/bill/116th-congress/house-bill/1384?r=16. Accessed Oct. 4, 2019.
WhiteHouse.gov. Executive order on protecting and improving Medicare for our nation’s seniors. Available at: https://www.whitehouse.gov/presidential-actions/executive-order-protecting-improving-medicare-nations-seniors/. Accessed Oct. 4, 2019.