Thursday, October 3, 2019


Office of the Press Secretary


The Sharon L. Morse Performing Arts Center
Ocala, Florida

1:47 P.M.  EDT

     THE PRESIDENT:  Well, thank you very much.  Special place.  Really special place.  But where I’m disappointed: I said, “We could have had 25,000 people if we did it outside.”  They said -- (applause).  Did you see all the people outside?  They all want your seat.  That’s the way life goes.  (Applause.)  And you’re not giving it up.  I know you too well.  You’re not going to give it up.  Please sit down.  Let’s enjoy it.  Let’s enjoy ourselves.

AUDIENCE MEMBER:  We love you, President Trump!

THE PRESIDENT:  No, you got tremendous crowds out there -- thank you.  I love your leg.  Look at that, he has my name tattooed on his leg.  (Applause.)  How did you get to The Villages?  How do you get to The Villages?  Huh?  That’s great.

But I’m thrilled to be here in one of the most famous and thriving communities anywhere in Florida, and really anywhere in the world, as far as I’m concerned -- The Villages.  (Applause.)

In fact, I was thinking about moving to The Villages, but I just couldn’t leave Mar-a-Lago.  I couldn’t leave it.  (Laughter.)  I got stuck at Mar-a-Lago.  I don’t know.

But this has been a great area for us, and it’s been a great part of our victory.  I don’t know if we got 100 percent, Ron, but it was pretty close, right?  Anybody in there didn’t vote for us, right?  No, we love it.  And we met the folks that built The Villages and that run The Villages, and they’re out here someplace.  And they’ve done a fantastic job.  Where are they?  Where -- they’re here some place.  Stand up, please.  (Applause.)  What a job you’ve done.  Great job.  Great job.  And that was started with your grandfather and your father and you folks.  And what a great job you’ve done.

You know, in my old days, I would have been jealous.  Now I couldn’t care less about them.  (Laughter.)  It’s amazing.  It’s amazing how being President can do that to you.  (Laughter.)

So in my campaign for President, I made you a sacred pledge that I would strengthen, protect, and defend Medicare for all of our senior citizens.  And you see it’s under siege, but it’s not going to happen.  (Applause.)

Today, I will sign a very historic executive order that does exactly that: We are making your Medicare even better, and we are not letting anyone -- it will never be taken away from you.  We’re not letting anyone get close.  (Applause.)

You see these people on the other side?  These people are crazy, by the way.  They’re totally crazy.  (Laughter and applause.)  But they want to take it away and give you lousy healthcare.  It’s pretty incredible.  You want to keep your doctors, right?  Remember, with Obama -- President Obama, right?  He said, “You can keep your doctor.  You can keep your plan.”  That didn’t work out too well for the people.

AUDIENCE:  Booo --

AUDIENCE MEMBER:  We’re trying to forget.

THE PRESIDENT:  Twenty-eight times.  He said he’s trying to forget.  (Laughter.)  You better never forget, okay?  Never forget.

As long as I’m President, no one will lay a hand on your Medicare benefits.  And that’s what we’re here to do today.  (Applause.)

This order is the latest step in my administration’s drive to ensure the world’s best healthcare for all Americans.  Together, we’re creating a healthcare system that protects vulnerable patients, makes healthcare more affordable, gives you more choice and control, and delivers the high-quality care Americans deserve.  And that’s what we’re doing -- we’re strengthening our healthcare system to a level that nobody thought would be possible.

Our economy is booming.  We’re doing fantastically well.  I think it gets a little bit hurt by politics.  (Applause.)  But our country is so strong and our economy is so powerful that even politics, and even when you have the -- the “Do-Nothings” -- I call them the -- really, the “Do-Nothing Dems.”  They can’t even affect it very much.  (Applause.)

We’ve created over 6 million new jobs since the election.  The unemployment rate has reached a 51-year low.  Two point -- think of that.  Think of that.  (Applause.)  Then, soon, it’s going to be a historic number, like so many of the other numbers.

2.5 million people have been lifted out of poverty.  That means more Americans that now have -- and that’s what it’s all about -- they have a great way of life.  They have affordable healthcare options and millions of seniors are enjoying better, healthier, and more prosperous retirements.  I should be retiring with you.  (Applause.)  I should be in this audience, clapping.  But I didn’t trust anybody to be standing here, because I know what you have.  (Applause.)

AUDIENCE:  Four more years!  Four more years!  Four more years!

THE PRESIDENT:  Thank you very much.  It’s true.  I didn’t trust anybody.  It’s very important.

And nobody has done more in two and a half years -- their first two and a half years -- than what we’ve done.  Whether it’s Right to Try, whether it’s tax cuts -- no matter what it is, nobody has done we’ve done.  Not even close. 

We’re delighted to be joined today by a man who is really, really good at -- he ran one of the largest drug companies, and really successfully, and I took him out.  Look, that’s where, you know, like -- that’s where the money is.  Well, that’s where the knowledge is.

He ran one of the biggest, most successful companies.  I said, “Alex Azar, come on out.  I want to get you to be the top person in charge of this.”  I said, “So, let me ask you, how much bigger is this than the company you’re in?”  It’s like hundreds of times bigger.  It’s a monster.  It’s a monster.  And what a job.  Alex Azar, you know who he is.  Where is Alex?  (Applause.)  Wherever you are.  Alex, thank you.

And he works with Administrator Seema Verma, who has been so incredible.  Seema, you have to stand up. What a job.  (Applause.)

They know the most intricate little quarter sentences.  You wouldn’t believe it.  I'd say, "What about this?"  And they'd tell me, "Unfortunately, it's always like a little roadblock, but we figure our way around."

And somebody else who is going to be lowering your drug prices with us in a very, very short distance.  We're going to buying them from a slightly different source.  A little bit unconventional.  A lot of people say I'm unconventional; sometimes you have to be unconventional.  (Applause.)

And, Alex, when are we are going to let Governor Ron DeSantis and your incredible First Lady Casey DeSantis -- when are they going to be -- when are they going to be able to do what we want to do?  (Applause.)  Alex, when are they going to be able to do what we have to do?  “Soon.”  Alex says, "Soon."  Because they're going to have a big fat, beautiful surprise for you.  And that has been an incredible couple and a great governor, and the job they're doing is phenomenal.  And I was honored to be very much involved in that campaign.  (Applause.)

And if he was doing a lousy job, I'd probably just wouldn’t have shown up today.  (Laughter.)  But he's doing one of the best jobs in the whole country.  Ron DeSantis.  (Applause.) 

And also helping Ron and Casey: Jeanette Núñez, your Lieutenant Governor.  Jeanette, thank you.  (Applause.)  Thank you.  Thank you.  Thanks, Jeanette.  Great job.

Florida Attorney General Ashley Moody.  (Applause.)  Ashley, I saw you down there.  Thank you.  (Applause.)  Thank you.  Thank you very much.

And a few warriors we have with us.  You know, Ron was one of our warriors.  He was in Congress and he was fighting the Russian hoax.  That was the Russian witch hunt hoax.  And he was so impressive that when he said, "You know, I'd like to run for governor," I said, "I'd rather keep you right where you are because they'll come up with another crazy idea."  But I'm glad I did it.  And it worked out well.
But we have warriors back in Washington, and you have five of them right here.  Gus Bilirakis.  (Applause.)  Gus.  Where's Gus?  Thank you, Gus.  Great job.  The legendary Neal Dunn.  (Applause.)  Neal, thank you.  These guys are warriors.  Ross Spano.  (Applause.)  Thanks, Ross.  Michael Waltz.  (Applause.)  Michael.  Great job he does on television.  All of them, they do a great job.  They're defending us.  They're not defending me; they're defending us, because that was the greatest election victory maybe in history.  And they're defending us.  (Applause.)

And a man with one of the best names in the history of politics: Daniel Webster.  (Applause.)  What a name.  If I had that name, I would’ve been President 10 years ago.  (Laughter.)  Thank you.  Thanks, Daniel.  Thanks, everybody.  Great job.

They really are -- they're warriors.  They go back and they fight, and they fight corruption.  And it's corruption, what’s going on right now.  When you see this going on, it’s pure corruption.

As we gather this afternoon, Medicare is under threat like never before.  Your know that.  You have people that are running for office who -- if it ever happened, you will not be very happy here.

Almost every major Democrat in Washington has backed a massive government healthcare takeover that would totally obliterate Medicare.  These Democrat policy proposals may go by different names -- they have all of these wonderful names like ---
AUDIENCE MEMBER:  Wacko! (Laughter.)

THE PRESIDENT:  It'll never end.  I'm sorry I smiled.  They’ll have me -- the fake news is back there.  Look at all of them.

AUDIENCE:  Booo --

THE PRESIDENT:  They'll say, “It's terrible.  It's terrible -- the President's smile."  You know, they want me to admonish you.  Who said that?  "Lock her up."  Stand up, please.  (Applause.)  I'm admonishing you.  Never ever say that again.  That’s okay.  Sit down.  (Laughter.)  He's admonished, so now they can't do their fake number on us.  Thank you.

     But they 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.  Any socialists in the room?  I don’t think so.  Not too many.  Anybody?

AUDIENCE:  Booo --

THE PRESIDENT:  No?  No?  Not too many in The villages.  You don’t -- you're not big on socialism down here, right?  These geniuses -- these real estate geniuses that know we're not -- not too good.

Every one of these plans involves rationing care, restricting access, denying coverage, slashing quality, and massively raising taxes.  They want to raise your taxes.

They also want to have open borders, so the people can just come in and do whatever they want to do.

AUDIENCE:  Booo --

THE PRESIDENT:  And they have no idea who's coming in, by the way.  They have no idea.  But, you know, when these countries -- and now we're getting along great with the countries.  Mexico gave us 27,000 soldiers guarding our border and the numbers are way down.  (Applause.)  Twenty-seven thousand.  I want to thank Mexico -- the government and the President.

Congressional Democrats’ extreme agenda would destroy our booming economy very quickly.  One of the most disturbing proposals from left-wing politicians involves draining your healthcare to finance the open borders that we just discussed.  That's how they want to finance it.  Leading Democrats have pledged to give free healthcare to illegal immigrants.  They put foreign citizens who break our laws and endanger our country -- they put them way ahead of American citizens like you who obey our laws.

I will never allow these politicians to steal your healthcare and give it away to illegal aliens.  (Applause.)  And now, in New York, I hear they passed a new regulation that, if you use the word, "illegal immigrant" -- did I hear correctly?  They want to charge you a fine of $250,000.  In other words, sell your home in The Villages because you happened to say, "We don't like illegal immigrants pouring into our country illegally.”  We want people to come into our country legally, through a process.  And we're all in favor of that.  (Applause.)

And, by the way, the Fake News will cut that last part of the sentence off.  (Laughter.)  They'll just put the first part.  And they'll say, "Man, is he rough?  He's too tough.  I can't vote for him."

A nation must put its own citizens first.  My administration is standing up for American seniors.  (Applause.)  And we'll always protect the Medicare benefits you earned and paid for.

In the last administration, Democrats slashed Medicare by $800 billion dollars to pay for Obamacare.  Not too good -- Obamacare.

AUDIENCE:  Booo --

THE PRESIDENT:  Now one of their new proposals, backed by more than 130 Democrat members of Congress, would cost -- listen to this number -- $32 trillion dollars.  And that's on the low side -- $32 trillion, with a "T".  We're beyond the "B's", the billions.  And reduce Americans’ household income by $17,000 per year.  Is there anybody in this room that doesn't mind losing $17,000 a year?  No?  In order to get lousy healthcare.

Though they use many labels, all of the Democrat plans would devastate our healthcare system.  The fake moderates on the left are telling the same lies they did under the last administration.  But the last administration, frankly, was moderate compared to the maniacs that you're hearing from today.  These are maniacs.  (Applause.)

Elizabeth "Pocahontas" Warren.  You know, when I used to hit her, I thought she was gone, Ron.  I thought she was gone.  She came up from the ashes.  She emerged.  (Laughter.)  Now, we're probably going to have to do it again, because I don't see Sleepy Joe making it, I'll tell you.  (Laughter and applause.)  No, I thought she was gone.

Under this administration, we believe that every American family has a right of choice -- you have a right to choose.  Choice.  So important.  Like what we did with the vets.  Choice.  Where they can go out and get a doctor instead of waiting in line for three weeks, four weeks, two months.  (Applause.)  Choice.  And you look at the doctor and you look at the plan that is best for you.

The truth is, there is no longer a moderate wing of congressional Democrats.  They've gone crazy.  They've been hijacked by the radical left.  I mean, these people on the left, these people are --

AUDIENCE MEMBER:  Wacko!  (Laughter.)

THE PRESIDENT:   (Laughs.)  Is that the same guy?  I think so.  (Laughter.)  I sort of like him.  I can't admonish him again.  (Laughter.)  I think it's the same guy.  Got a powerful voice.

Democrat lawmakers are not trying to build up the country; they only want to wreck and destroy all of the things that we've built up over the last three and a half years, four years, five years -- (applause) -- prior to us getting in here.  You look at the stock market numbers from the time of the election, from that November 9th date, go a date later.  Wasn't November 8 -- was that one of the great times?  Huh?  (Applause.)  2016.

But go a day later, and you look at the numbers in the stock market up way over 50 percent.  The 401(k)s are doing unbelievably well.  One of these people gets in -- your 401(k)s are going to hell, the stock market is going to hell.  Frankly, I think -- and I hate to say it -- the country is going to go to hell.  (Applause.)

They're consumed by rage and radicalism and insatiable lust for power.  Well, how about Justice Kavanaugh?  They talk about a woman -- (applause).  They talk about a woman, about horrible things that he never even thought about.  Horrible, horrible things.  And the following day, they want to impeach him.  And then, the following day, she said, "No, I don't remember anything.  I don't remember that."  And they say, "We don't care.  We want to impeach him anyway."  Now, what they're trying to do is turn his vote liberal.  But he's a much tougher guy than that.  (Applause.)  I hope.  (Laughs.)  He's a much tougher guy.


THE PRESIDENT:  Thank you. Yeah, I better be.  I'll tell you.  If I weren't, I wouldn't be up here right now.  With all that we have to put up with these people, we wouldn't be here.

Democrat healthcare proposals would put everyone into a single, socialist, government-run program that would end private insurance for over 180 million Americans.  I’m sort of smiling to myself as I -- as I go through these numbers.  And I’m dealing with people that I know.  I mean, I know the people in this room.  Those are the people.  I grew up with you.  When we were young, I grew up with you.  And now we’re sort of still young at heart, at least.  (Applause.)

And that I’m even talking about socialism is like -- it’s just -- it’s sort of a weird feeling to be talking to you about “you don’t want to be socialist.”  And you’re probably saying, “Why is he wasting his time?”  (Laughter.)

But there’s a movement on.  And it’s not so easy to be beat them when they get up in a debate and they say, “We’re going to cut your college tuition to nothing.  We’re going kno- -- knock off $1.6 trillion.  We’re going to do all these other things.  Everything is free, except for your taxes.”  Your taxes are going to go up at a level that nobody has even seen before and that won’t be nearly enough to pay for it.

But I’ll not let any of this bad stuff happen.  It’s very important that we win this race.  You know, when we won last time, I said, “That’s the most important election in our country’s history.”  Because we were ready to go over the edge.  (Applause.)

And now our country is doing great.  But, you know, it’s like a plant -- it’s like a tree.  It has to grab -- those roots have to grab hold.  We still need more time.  We’ve done so much, but we need a little more time.  That thing has to grow and it’s got to get in there and then nobody is going to be able to take it down no matter what happens later on.  So important. (Applause.)

In America, we believe in freedom and liberty, not government domination and government control.  Today, standing in solidarity with our nation’s seniors, I declare once again that America will never be a socialist country -- it will never be.  (Applause.)  Thank you.

AUDIENCE:  Four more years!  Four more years!  Four more years!

THE PRESIDENT:  You want to drive them crazy?  Don’t do “four more years.”  Say “eight more years.”  You’ll drive them crazy.  (Laughter.)

One of these crazy maniacs on a show was interviewing somebody -- radical Left -- and he goes, “You know he’s going to win, don’t you?”  Big show.  And the guy goes, “No, no.  We’re going to fight him.  We’re going to…”  “No, no, no.  He’s going to win.  And you know he’s never getting out.  You know that don’t you?”  (Laughter.)  “He’s not going to get out.  You know he’s…”

And I thought, like -- you know, he’s a comedian.  I thought he was like kidding and having fun.  He meant it.  (Laughter.)  These people are sick.  They meant it.

Anyway -- but, no, if you want to drive them crazy, just say “eight more years” or “twelve more years” -- (laughter) -- or “sixteen.”  Sixteen would do it good.  They would -- (laughter) -- you would really drive them into the loony bin.  (Applause.)

And that’s why they do the impeachment crap, because they know they can’t beat us fairly.  That’s the only reason they’re doing it.  They can’t win.  They can’t win.  (Applause.)  If they won, it would be a sad day for our country.  It’ll be a sad, sad day for our country if they ever won.          
Among those who would be hit hardest by the socialist takeover are 24 million seniors on Medicare Advantage -- a lot of you.  One out of two Hispanic seniors, one out of three African-American seniors is enrolled in Medicare Advantage.  This very popular Medicare program -- been around for a long time -- allows private plans to compete to offer senior citizens the absolute best healthcare.  They want to destroy it.

While many Democrat plans would eliminate Medicare Advantage, my administration is fighting to make it even better and much, much stronger. (Applause.)

And thanks to our efforts, there are nearly 1,200 more Medicare Advantage plans today than there were just two years ago.  Think of that.  (Applause.)  Premiums have plummeted by 28 percent; they’ve gone down.  And they’re now at the lowest level in over 10 years.

      With us today is Corey Spangler.  She lives just up the road in Summerfield.  Corey, please tell us some of what we’ve been discussing on Medicare Advantage and your plan, and how important it is to you.  Please, come up, Corey, wherever you may be.  Oh, Corey.

      MS. SPANGLER:  I’m right here.  (Laughter and applause.)

      THE PRESIDENT:  Thank you, Corey.

      MS. SPANGLER:  Okay.  My family came to America from Mexico when I was five years old because my father did not like the corruption and we had socialized medicine there.  He came to this country legally.

      And when I turned 65, I had some heart issues.  I went to the doctor.  They scheduled me with a cardiologist.  He scheduled me for a stress test on a Wednesday.  Pass -- I didn’t -- I failed that test.  So he scheduled me for a heart cath the next day.  I failed that.  They told me you need to have a bypass and I was going to have five bypasses done.

The following Monday, I was in surgery with my five pass -- five bypasses, and I went home the following Friday.  This would never happen with Medicare for All.  I love my Medicare Advantage plan, because I can choose the doctor, when I need it, and get the care I need in a quickly manner.  And it wouldn’t happen with Medicare for All.  (Applause.)

      THE PRESIDENT:  That’s beautiful.

      MS. SPANGLER:  Thank you, Mr. President, for saving my care -- healthcare.

      THE PRESIDENT:  Thank you, Corey.  (Applause.)

      I see a future politician there.  That was -- (laughter) -- boy, she was so like calm.  No nerves.  You know, sometimes I’ll see people, they get a little bit nervous.  Very good.
      What a job they’ve done.  Great doctors.  Did you choose your own doctor or you get lucky with a good doctor that was recommended?

      MS. SPANGLER:  They were wonderful.

      THE PRESIDENT:  They were wonderful.  That’s fantastic.  And you’re wonderful.  Thank you, Corey.  Appreciate it.  (Applause.)

      The Democrat plans for socialized medicine will not just put doctors and hospitals out of business, they’ll also deny your treatment and everything that you need.  Government-run healthcare systems always end up imposing rationing.  You see what happens.

      You look at Venezuela; take a look at that.  Fifteen years ago, it’s one of the wealthiest countries.  Now they don’t have food.  They don’t have water.  The hospitals are a disaster.  No electricity.  No anything.  It’s very sad.  And we’re helping the people as much as we can.  But we’re watching that whole situation -- beyond this, we’re watching it very, very carefully.   We’re watching it very carefully.  And Cuba -- we’re watching Cuba very carefully.  Very, very carefully.  (Applause.)

      But as an example, under the United Kingdom’s single-payer system, patients wait 117 days to receive, as an example, a knee replacement.  One hundred and seventeen days.

In Canada, wait times for orthopedic surgery are over 270 days.  But currently in the United States, wait times for these surgeries are -- we've speeded it up a lot -- are typically less than two weeks.  Is that right, Alex?  (Applause.)

And I have many people coming down from Canada, and I say, "What are you doing?"  They're getting an operation of some kind.  "Why don’t you get it up there?"  They said, "There's nothing like what you've been able to do in a short period of time."  And we're making it even better.

With us today is Charles McLaughlin, a 71-year-old Floridian and a Marine veteran of the Vietnam War.  Charles, please come up and tell us your story.  Please.  (Applause.)

MR. MCLAUGHLIN:  Oh, man.  (Applause.)

Hello to The Villages!  What a great place you guys have here.  Wow.  I understand that approximately 60 percent of all of you are veterans.  I want to say thank you for your service.  (Applause.)  And to my Vietnam brothers and sisters: Welcome home.
(Applause.)  Welcome home.

My name is Chuck McLaughlin, and I'm a Vietnam combat Marine.  I'm also a cancer survivor -- Stage 4 style.  I know a lot about Medicare and the supplement.  I used it for breathing tubes, feeding tubes, stitches, staples, MRIs, PET scans, CAT scans, blood tests, hydration shots, chemo treatments, radiation treatments, six months of hypobaric chamber -- to name a few.

Anyone that's cured, like me, loves their doctors.  Loves their doctors.  (Applause.)  I also want to say: My family, financially, would've been destroyed without Medicare.  Destroyed.  The facts are now (inaudible) the politicians on the left are pushing Medicare for All.  I say the result will be no Medicare at all.  It will collapse under the load -- the load of the system.  It will overload of it.  The lines would be incredible.  Who knows?  I probably wouldn’t be here.

As far as free stuff, it may be free stuff, but it's going to come out of somebody else's pocket.  There's no such thing as "free."  Period.  (Applause.)

Is the Medicare system perfect?  No.  But it worked for me.  Remember, I paid my share.

     Just a few thoughts: President Trump's plan of Medicare Advantage will give me more flexibility for options to this system.  I can pick and choose my needs.  Secondly, a program that helps protect us seniors for a fair shake as our bodies fail us.  And number three, we must get rid of the waste and fraud that seems to be in the newspapers weekly.  Finally, thank you, President Trump, for all you do.  (Applause.)

     I want to personally thank him for what he does for our veterans.  (Applause.)

     Finally, and may God bless you and your family for loving America and giving us a renewed hope for our children and our grandchildren.  Thank you.  (Applause.)

     THE PRESIDENT:  What a great job.  Well, thank you very much, Charles.  And it's incredible.  You've gone through a lot.

     MR. MCLAUGHLIN:  Yep.

     THE PRESIDENT:  You don’t look it.  (Laughter.)  He's looking handsome to me, I'll tell you.  (Laughter.)  Thanks, Charles.  That's incredible.

     Like you, all of us today understand the truth.  Socialism is not about improving the health of American people; it's about wielding power over the American people, taking things away from the American people.  (Applause.)

In a few moments, I will sign an executive order to strengthen Medicare for seniors, and very substantially.  I'll provide Medicare Advantage plans with new tools and options, and it will help Medicare beneficiaries gain faster access to the very latest and greatest medical devices and therapies.

My order also pursues reductions in the unnecessary regulations that you don’t need, you don’t want to see -- that never come into effect and that cost a lot of money -- enabling doctors and nurses to spend less time on paperwork and more time with their patients that they love.  (Applause.)

To further protect seniors, we are taking action to stop fraud and to stop abuse.  It's tremendous amounts of money saved with that.  And we'll be able to put that money right back into what we want to have it to take care of you.

I'm directing Secretary Azar to crack down on criminals, cheaters, and dishonest providers who rob Medicare of the funds you have and the money that you've paid into the system all of your lives.  Charles said it.  Charles said, "You know, I paid for it."  He said he paid for it.  And now they want to say, "Let's give it to everybody else."  And it's going to be gone in a very short number of years.  But you did pay for it.  You both paid for it.

Today’s action is the only really great action that we can take.  It's the only choice we have because this is going to be something that's better than any place anywhere in the world.  It's the latest of many important steps that we're taking to dramatically improve healthcare for the American people.

Our vision for the future of health in America has four crucial parts.  And we will protect vulnerable patients, number one.  We will protect those patients that are so terribly vulnerable.  We will deliver the affordability that you need.  Prices coming down.  As I said, prescription drug prices -- first time in over 50 years, Alex, that drug prices have come down for the year.  (Applause.)  Your average prescription drug price -- first time in 50 years -- over 50 years.

And we're going to get them a lot lower.  And I think Ron is going to have some big surprises.  We'll be announcing that pretty soon.  Some -- for really, really big reductions.  People are already -- they're not even going to know what happened.  So that’s what we want.  (Applause.)

And we're going to give you options and control that you want.  And we will provide the quality you deserve.

First, we're protecting vulnerable Americans.
We have made a clear promise to America’s patients: We will always protect patients with preexisting conditions.  (Applause.)  The Republicans will always protect preexisting conditions.  (Applause.)

To stop families from being blindsided by outrageous medical bills -- and this is something that is one of the most exciting things to me -- I have challenged Congress to send a bill to my desk that stops the horrendous practice of surprise medical billing.  So many of you, you go in and you have something, and then you get a bill and you say, "How is it possible?"  And we're going to end that practice.  That practice is not a fair practice.  (Applause.)

And we're also confronting the opioid and drug addiction epidemic that is plaguing too many American communities.  And thanks to our efforts -- and we've worked so hard on it; the First Lady worked so hard.  Kellyanne Conway -- where's Kellyanne?  (Applause.)   Where's Kellyanne?  Where is she?  Kellyanne, thank you.  Thank you, Kellyanne.  (Applause.)

Last year, drug overdose deaths declined for the first time in nearly three decades.  Early data shows that drug overdose deaths dropped 10 percent last year in the state of Florida.  Now, think of that.  That’s -- you know, we'd like to better.  It's a very, very tough situation.  And one of the things we're doing with the "pain pills" -- we can call them -- we're trying to find, and we're really working hard and we're funding a lot of research to find pain pills that aren’t addictive.  You go into to a hospital with a broken arm, and you come out and you're drug addict.  And we're trying to find, and we're getting closer -- I think we're getting very close, actually -- to finding painkillers that aren’t addictive.  And we'll have that in the not-too-distant future.  (Applause.)

And to care for our great veterans, we passed VA Accountability.  You know what that is, right?  This is where the great heroes and tough people -- but -- and, by the way, in their super prime, nobody touched them.

But they're more vulnerable, and people would take advantage of our veterans.  You had sadists.  You had people that would rob them and rob the system.  You had some horrible people.   We couldn’t fire anybody.  They had, in Arizona, people that got stealing -- they got caught stealing $400,000.  They couldn’t fire them.  So now we have VA Accountability.  You think that was easy?  They've been trying to get it for 50 years.  And I got it.  I'm good at getting things.  (Applause.)

So now, when they don't take proper care of our vets, we say, "Jim, get the hell out of here.  You're fired.  Get out of here."  (Applause.)  We can fire them.  Get them out.  We get them out.  We don’t have to ask questions.  We get them out.  If they're bad, they treat our veterans badly, we fire them.  That's why you don't hear about -- you know, before me, every night you'd see these stories, these horror stories about the VA.  I haven't seen one in a long time.  Now, I don't want to wish it because the fake news will search the system -- (laughter) -- to find somebody that's not happy.  "We found somebody.  We found a vet in Florida who isn’t quite happy with everything.  Let's do a major story."

But do you remember all of the bad stories that used to be about the VA?  Now you don't see that because they have accountability.  We can fire bad people.  We fired a tremendous number of really bad people that should've been fired years ago.  (Applause.)

I don’t like firing people, but I like firing people that don't treat our vets great, that aren't doing their job.  And they were protected, frankly, by the unions, and they were protected by civil service -- very powerful.  Do you think it was easy beating unions and civil service?  Not too easy.  But I explained to them too.  I said, "This is good for all of us.  It's good for America."

And the other, as I said, is VA Choice, where our veterans no longer have to wait for endless, endless hours, days -- even months.  We've had cases where a person is on line -- not bad; could be fixed up very easily with whatever treatment it may be -- and they end up being terminal by the time they see a doctor.  That's not happening anymore.  (Applause.)  Because now you go out, you find a great local doctor, we pay the bill.

And, you know, it's interesting, it's totally less important but we also save a lot of money on that.  Hard to believe, we save a lot of money.  It's much less expensive for us to do that than the other way, and it's saving tremendous numbers of lives.  And we have great doctors, frankly, that need the business.  Not so bad.

To protect healthcare for our seniors and all Americans, my administration is taking strong actions to ensure that newcomers to our society do not drain our healthcare system, or burden the services that you depend on.  You see these people in California, the governor of California -- "Come on in, everybody."  Then you wonder why people are flooding our borders. "Come on in.  You have free education, free healthcare.  Everybody gets a Rolls-Royce."  (Laughter.)  "Come on in.  Come on in."

You know, to show you how corrupt CNN is, when I used that expression, they said, "The President wasn’t telling the truth.  He said they get a Rolls-Royce and they don’t."  (Laughter.)  Ahh, they don’t get it, do they?  They never got it.

Some idiot at CNN said, "You can't win without CNN.  I guess we showed them." (Laughter and applause.)  I guess we showed them.  (Applause.)  And their ratings are so low now that they are no longer the big difference at all.  They have really bad ratings.

But you know what is bad for our country?  When CNN -- so often I go to a foreign country.  I go to a country.  I meet leaders.  And he said, "Why do they hate your country so much?"  I said, "Who?"  You know, CNN outside of the United States is much more important than it is in the United States.  And a lot of what you see here is broadcast throughout the world.  And we used to have Radio Free -- I think Radio Free Europe and Voice of America.  And we did that to build up our country.  And that’s not working out too well.

But CNN is a voice that really seems to be the voice out there.  And it's a terrible thing for our country.  And we ought to start our network and put some real news out there because they are so bad.  (Applause.)  They are so bad for our country.  They are so bad for our country.  I go out there and they say, "Boy, the media hates your country."  And it's just a shame.  It's just a shame.  And we really are -- we are looking at that.  We should do something about it, too.  Put some really talented people and get a real voice out there, not a voice that's fake.

When Americans are struck by natural disaster, like they were in Florida where I was with you, Hurricane Michael -- did I do a good job, Governor?  Did I do a good job?  (Applause.)  Man.

Your governor came to my office once a week.  He always needed more money -- (laughter) -- and I always gave it, right?  He didn't stop.  I hated it.  I said, "Keep DeSantis.  I don’t want to see him anymore."  (Laughter.)  But we always gave it, and you got it.  And your people worked so hard.  And FEMA and the military, they all worked with you.  The Coast Guard is incredible, what the Coast Guard has done.  (Applause.)  I think the Coast Guard has really done a great job. 

The second part of our healthcare agenda is to promote the affordability of America's needs.  Thanks to our focus on lower drug prices, the FDA approved more low-cost generic drugs in my first two years than ever before in the history of our country. Think of that.  Think of that.  (Applause.)

And every time I'd see the folks over at FDA, I'd say, "Come on, fellas.  Let's go.  Faster.  Faster."  You know, don't forget, when somebody was dying and we had a drug that looked like it was really good but it wasn't going be approved for like four more years -- it used to be 12 years and we brought it way down.  I mean, it's too long.  But we brought it way, way down.  But a person is dying and they said, "No, sir, we can't give that because it may harm the person."  I said, "Wait a minute, you don’t understand."  (Laughter.)  "A person is terminally ill, they've got four weeks to live, and you don't want to give them a drug because you think it's going to harm them?  I guarantee you I can get them to sign a document."  (Laughter.)

Now we got that approved -- Right to Try.  And, by the way, miracles are happening.  Right?  Miracles.  (Applause.)  Miracles are happening.

Hopefully, it never happens to anybody in this room.  But, frankly, people would go to Asia, they'd go to Europe, they'd go all over the world seeking a cure, if they had money.  If they didn’t have money, they'd go home and they'd die.  But now they don't have to do that.

And it wasn't easy because the drug companies didn't want it because they didn't want to have terminally ill because it looks bad on the percentage record, right?  The insurance companies didn't want it because there are a lot of reasons.  You know what the reasons are.  Our government didn't want it because they didn’t want to be sued by a patient that died that would've died anyway.  So I said, "Here's what we do, folks: We sign an agreement.  And the agreement holds everybody non-liable."

We took the drug companies and we created a separate list, so they're not on that list -- because it is, right?  It's a problem.  And we took a separate list.  So now we have a totally separate list -- confidential list -- but they don't get hurt by somebody that was so sick that this person may not make it.  And I got everybody to sign it and we were done.  It was pretty amazing.  And then we got it approved in Congress because of these five great congressmen back there, including Ron, who at the time was in Congress.  (Applause.)  Right?  With Greg and everybody, we got it done and we got the Senate to approve it.  And I signed it.  And I was really happy.  Right to Try.  Hopefully you never need it.

We also ended the terrible gag clauses that prevented pharmacists from telling you about cheaper options at the pharmacy counter.  Do you believe it?  I thought this was -- I thought they were kidding me the first time.  Don’t forget, I've only been doing this for three years, okay?  So, you know.  (Laughter.)

These guys have been doing it a long time.  But they're not allowed to talk to you about pricing.  I said, "Wait.  You've got to be kidding."  And they weren’t.  But I got rid of that.  Now they can talk about pricing.  You can go out and price.  You can go to different places.  They have to be open and transparent.  That was a big deal.  (Applause.)  That was a big deal.  (Applause.)

And all of these things, you know, they sound so simple; they're tough to get.  They've been that way for many years for a reason.  You have very powerful lobbyists.  You have drug companies, frankly, that don’t want that.  Why would they want that, where you can negotiate price?  Why would they want a thing like that?

My administration is also working to require drug companies to disclose prices in their television advertisements.  And we’re almost getting to a point where we’re going to be able to get that.   So you’re going to know what you’re paying up front.  They can’t triple-hit you.  (Applause.)

Essentially, we’re holding Big Pharma accountable.  And that's okay; they do just fine.

Earlier this year, we announced another groundbreaking action seniors have wanted for decades.  We will soon allow the safe and legal importation of prescription drugs from other countries, including the country of Canada, where, believe it or not, they pay much less money for the exact same drug.  (Applause.)  Stand up, Ron.  Boy, he wants this so badly.  (Applause.)

No, I mean, you go to some countries and the price is like 50, 60 percent lower -- even more than that, I guess, Ron, in some cases.  And it’s 50, 60 percent lower -- the exact same pill, from the exact same factory, from the exact same company.  And I say, “Why is it that in Europe -- certain places, in particular -- it's 25 percent of what we pay back here?”  I said, “It must be a different manufacturer.”  “No, sir, it’s the same one.”  “Must be made in a different factory.”  “No, sir, it’s the same one.”  Everything is identical; they pay 25 percent.  We pick up all of the research and development.  We pick up everything like a bunch of, excuse me, schmucks.  (Laughter.)  Schmucks.  Right?  (Applause.)

Not anymore, folks, because in a little while -- (applause) -- in a little while, your governor is going to be able to go out and negotiate until his heart is content.  And he’s going to go to Canada.  I know he’s gone there already and he’s looking at their pricing, and he’s going to some of the European countries and others, and he’s going to get his drug price down to a level that you can’t believe.  It’s going to be a great thing.  And we’ll see what happens.  It’s going to be very interesting.  (Applause.)    

And 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, I think.

Now, they’re very smart.  They may go the other way, and if they do, don’t blame me, okay?  (Laughter.)  But I’m pretty sure you’re going to do fantastically, Ron.  You feel good about it?  Huh?  You better do good; otherwise, you’re making us both look bad.  (Laughter.)  You hear that, Casey? 

American patients must no longer be forced to subsidize lower drug prices in other countries through higher prices in America.  That's what we were doing.  We were paying a much higher price.  My administration will never stop fighting for lower costs for American patients and American seniors.

The third part of our healthcare vision is to provide the choice and control Americans want.  We eliminated Obamacare’s horrible, horrible, very expensive and very unfair, unpopular individual mandate.  A total disaster.  That was a big penalty.  (Applause.)  That was a big thing.  Where you paid a lot of money for the privilege of not having to pay a lot of money for the privilege of having no healthcare.  You paid not to have healthcare.  It was a penalty.  And how it ever held up in Supreme Court, I don’t know, but it did.  But we just got rid of it.  We just did it the old-fashioned way: We got rid of it.

We vastly expanded affordable insurance options, including association health plans, short-term plans, and health reimbursement arrangements -- which are incredible.  And many of these options are up to 60 percent less expensive than "O-bomb-a-care."  (Applause.)  Nobody got that.  (Laughs.)  Nobody got that.  That’s okay.  "O-bomb-a-care."  I didn’t say “Obamacare.”  I said "O-bomb-a-care."  (Laughter.)  President "O-bomb-a-care."  He can have it.

But we’ve done a great job in running it.  We almost had it done.  We unfortunately had one vote -- middle of the night -- just when thumbs down.  That wasn't good.  After years and years of campaigning -- "repeal and replace," right?  But we've done a great job because we get rid of the individual mandate.  And we’re running it better.  It’s still no good, because it's too expensive.  The premium is way too high and all of the elements of it.  It’s just not good.  But we’re coming up with an incredible plan that if the Republicans take back the House, keep the Senate, keep the presidency, we’re going to have a fantastic plan.  (Applause.)  Right?

Following my administration’s recommendation, Florida has taken an important step to lower cost and increase choice by repealing a misguided Certificate of Need law, used by hospitals to block competition.  We encourage other states to follow Florida’s example.  They’ve done a great job right here.  (Applause.)

And I also signed, just recently, a revolutionary executive order requiring price and quality transparency.  And the man who's really the leader in the world of this -- it’s transparency.  You can pick your doctor; you can look at their records; you can see how well they did.  You can go and negotiate.  A man -- what really sold me on it -- the man who's the best in the world at it, who we used, and we gave you the max plan.  Did we give that?  The max plan, right?  That’s the maximum plan.  We gave it to you.  And he said something that I loved.  He said, “Sir, this is more important and will go down as more important than any healthcare that you’ll ever come up with.”  And I said, “I like the sound of that.”  Now, who knows if it’s true, but I guess, from what I’m hearing, they’ve done it in certain limited areas and it’s phenomenal.

And it’s really transparency.  And you’ll be able to negotiate all over the place.  And you’ll be able to pick everything you want, from the hospital to the doctor.  And it’s going to save you a tremendous amount of money.  And there are those that say it’s more important than even healthcare at a high -- at a high level.

And fourth, my administration is fighting to ensure the high-quality care that Americans deserve.  Americans have to get the highest quality.  So we have the highest quality that Americans deserve.

On behalf of 5 million Americans living with Alzheimer's disease, I signed into law a $1 billion increase in funding for critical Alzheimer’s research.  And we’ve made a lot of progress.  (Applause.)

And just one other thing I will tell you -- because it even surprised me -- but we've funded it now, and, within 10 years, our country will be AIDS-free.  Can you believe that?  AIDS-free.  (Applause.)  Tremendous progress has been made.

And when we were talking about that, I said, "I don't understand.  How does this…”  It's like somewhat of a secret, but it's incredible -- the tremendous progress that we've made over the last few years on AIDS and AIDS research.  And we should be essentially AIDS-free.  Do you agree with that, Mr. Secretary?

In my State of the Union, I announced a plan to invest -- (laughs) -- she liked it -- $500 million dollars in new treatments, and cures, and all of the things that we have to go through with our incredible children, in some cases, for childhood cancers.  It's a tremendous problem.

And to bring new hope to the nearly 100,000 Americans currently awaiting a kidney operation, I signed an executive order that will significantly increase the supply of kidneys available for transplant.  It's such a big deal.  It’s so big.  You have no idea.  (Applause.)

And we worked hard on that.  And, you know, what a lot of people don't know -- a lot of it is just the work.  The people die fairly quickly because it's not -- they could go on forever.  But it's -- it's unbelievable amounts of work, going in all the time for step-by-step -- what you have to do.

And so, with kidney transplants, we're making tremendous progress.  And we funded a lot of money toward it.  And I think it's going to be a tremendous thing for people that are just literally suffering with something they can really do very well with.

We're delivering better, fairer, and more affordable healthcare for all Americans, especially our cherished senior citizens.  And we will stop at nothing to deliver better healthcare for you and for your family.  I will never let you down.  You have been incredible to me and I will never ever forget you.  I will never let you down.  I promise that.  (Applause.)  Thank you.  Thank you very much.

We're lowering the cost of prescription drugs, taking on the pharmaceutical companies.  And you think that's easy? It's not easy.  It's not easy.  They come at you from all different sides.  I wouldn't be surprised if the hoax didn't come a little bit from some of the people that we're taking on.  They're very powerful.  They spend a lot of money -- spend, I think, more money than any other group in the world actually, in terms of lobbying and lobbying abilities.

And I wouldn't be surprised if some of the nonsense that we all have to go through, but that I go through -- wouldn't be surprised if it was from these -- some of these industries like pharmaceuticals that we take on because I want -- I don't care.  I did great.  I've had a great life.  I want to get drug prices down.  I don't care about the companies I want to get drug prices down.

I want to continue to give them the incentive to come out with new and better answers, but got to get drug prices down.  And they've made a fortune over the last 40 years.  They've made so much money.  And they've got the system wired.  Because everything you do, their stock goes up.  I said, "What the hell is going on?  Their stock just went up."  They said, "Sir, it's going to be wonderful."  I said, "It's not going to be wonderful."  Let their stock go down a little bit.  But their stock goes up.  And what we've done is incredible.

And, by the way, you have some incredible companies.  The answers that they -- we -- we want to keep them strong and powerful and wealthy, and we want them to con- -- really continue to do that research.  But we got to get those prices down.  They're far too high, especially when you compare them to other countries.

And we want to ensure access to the doctors of your choice.  And every day, we are going to -- as I said, we are going to defend Medicare like Medicare has never been defended again.  And it's never needed the defense.  It's always been incredible.  It's something that worked and they want to destroy it.

In my administration, we know that Medicare is personal.  Great healthcare is about more time with the ones you love, more days with your grandkids, and more freedom to enjoy the most rewarding years of your life -- or what should be, by far, the most rewarding years of your life.  You've worked hard.  You've worked so hard.  And you paid for it.  And you've got to enjoy it.  It’s about getting better when you’re sick, it's improving your well-being, and it's getting the treatment you need, right when you need it.

That's why, in everything we do, we are defending the principles that made America the envy of the world and the American way of life the greatest in our history.  And our country has never been greater than it's been right now.  Our military is the strongest it's ever built -- we rebuilt our entire military.  (Applause.)

And even medical research is at a new level.  It's at a level that we've never had it before.

We stand for freedom.  We stand for choice.  We stand for justice, and fairness, and accountability.  We stand for loyalty to our citizens, love for our country, allegiance to our flag, and long and healthy lives for our great seniors.  (Applause.)

And with your help, we are going to continue building the best, most advanced, most cutting-edge healthcare system anywhere in the world.  We are going to expand our growing economy to make retirement easier, and better, and far more secure.  We're going to defend American lives, American values, American families, and America’s glorious destiny.  There is no country like our country.  (Applause.)  We see and read things, but there is no country like our country.  Right?

With every ounce of strength and every bit of soul, we are going to protect Medicare for you -- for everyone at The Villages, and for every senior across this magnificent land.

You are going to be protected in many ways -- but you are going to be protected.

Thank you very being here.  Thank you for this incredible enthusiasm.  God bless you.  God bless our senior citizens.  And God bless America.  Thank you very much, everybody.  Thank you.

     Okay.  Should I do it?  (Applause.)  I'll do it.  All right.

     (The executive order is signed.)  (Applause.)

     Thank you everybody.  Here -- grab these, fellas.  Pass them around.  The congressmen don’t want (inaudible), and I know that.  Here you go.  I love that.  I love that.  I love those guys.  “Bikers for 45.”  These guys.  (Laughter and applause.)  They’ve been there from the beginning, right?  Here.  Pass them around.  Pass these around, fellas.  Pass them around.

Come here.  Attorney General, get over here.  Come on.  Get over here.  Lieutenant Governor, come on.  Please, both of you.  Come on up here.  They’re doing a good job, right?  Should we give them a pen?  I think so.  (Applause.)  Come on up here.  That’s great.

I want to thank you all.  Really a special time.  And this is -- this is very meaningful for me and for you and for everybody.  Thank you all very much.  Thank you.  (Applause.)

                          END                2:49 P.M. EDT      


Statement from the Press Secretary

Office of the Press Secretary
Statement from the Press Secretary
The United States supports Egypt, Ethiopia, and Sudan’s ongoing negotiations to reach a cooperative, sustainable, and mutually beneficial agreement on filling and operating the Grand Ethiopian Renaissance Dam.  All Nile Valley countries have a right to economic development and prosperity.  The Administration calls on all sides to put forth good faith efforts to reach an agreement that preserves those rights, while simultaneously respecting each other’s Nile water equities.

1600 Daily The White House • October 3, 2019 President Trump is Protecting Medicare for America’s Seniors

1600 Daily
The White House • October 3, 2019

President Trump is protecting Medicare for America’s seniors 

Today, President Donald J. Trump traveled to The Villages, Florida, outlining how he will protect Medicare for our Nation's seniors. In doing so, he offered a clear contrast to Congressional Democrats’ socialist takeover vision for the public.

A message to America’s seniors: “No one will lay a hand on your Medicare benefits.”

“I made you a sacred pledge that I would strengthen, protect, and defend Medicare for our senior citizens,” President Trump said. “Today, I will sign a historic executive order that does exactly that: We are making your Medicare even better—and we are not letting anyone take it away.”

The newly signed Executive Order will improve service to American seniors in many ways. First, it will empower patients by giving them more plan choices, more access to new therapies, and more time with providers. It will also maximize freedom for patients and providers by reducing regulatory burdens and eliminating unnecessary barriers.

But most important, it will improve the fiscal sustainability of Medicare overall, ensuring that it will always be there for those who need it most.

In the Sunshine State alone, more than 4.5 million people are currently enrolled in Medicare. Today’s announcement was just the latest bit of welcome news for Floridians as part of the President’s economic agenda for working Americans. More than 550,000 jobs have been added there since the election, and the state’s unemployment rate has been reduced from 4.7 percent to 3.3 percent.

“Medicare is under threat like never before. Almost every major Democrat in Washington has backed a massive government healthcare takeover that would obliterate Medicare.”

The left’s “Medicare-for-All” vision is a dangerous proposal, to put it lightly, threatening to end the Medicare program as we know it and eliminate choice for America’s seniors. If it is ever implemented, the end result would be Medicare-for-none.

Democrats lied about Obamacare then. They’re lying about Medicare-for-All now.

President Trump’s healthcare vision: Puts America’s seniors and patients first

Photo of the Day

Official White House Photo by Tia Dufour
President Trump speaks with reporters prior to his trip to The Villages, Florida | October 3, 2019

Executive Order on Protecting and Improving Medicare for Our Nation's Seniors

Office of the Press Secretary

- - - - - - -


    By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered as follows:

    Section 1.  Purpose.  The proposed Medicare for All Act of 2019, as introduced in the Senate ("Medicare for All") would destroy our current Medicare program, which enables our Nation's seniors and other vulnerable Americans to receive affordable, high-quality care from providers of their choice.  Rather than upend Medicare as we know it, my Administration will protect and improve it.

    America's seniors are overwhelmingly satisfied with their Medicare coverage.  The vast majority of seniors believe that the program delivers high-quality health outcomes.  Medicare empowers seniors to choose their own providers and the type of health insurance that works best for them, whether it is fee for-service (FFS) Medicare, in which the Federal Government pays for covered services, or Medicare Advantage (MA), in which Medicare dollars are used to purchase qualified private health insurance.  "Medicare for All" would take away the choices currently available within Medicare and centralize even more power in Washington, harming seniors and other Medicare beneficiaries.  Throughout their lives, workers and their employers have contributed their own money to the Medicare Trust Fund.  It would be a mistake to eliminate Americans' healthcare choices and to force them into a new system that is effectively a Government takeover of their healthcare.

    "Medicare for All" would not only hurt America's seniors, it would also eliminate health choices for all Americans.  Instead of picking the health insurance that best meets their needs, Americans would generally be subject to a single, Government-run system.  Private insurance for traditional health services, upon which millions of Americans depend, would be prohibited.  States would be hindered from offering the types of insurance that work best for their citizens.  The Secretary of Health and Human Services (Secretary) would have the authority to control and approve health expenditures; such a system could create, among other problems, delays for patients in receiving needed care.  To pay for this system, the Federal Government would compel Americans to pay more in taxes.  No one -- neither seniors nor any American -- would have the same options to choose their health coverage as they do now.

    Instead of ending the current Medicare program and eliminating health choices for all Americans, my Administration will continue to protect and improve Medicare by building on those aspects of the program that work well, including the market-based approaches in the current system.  The MA component, for example, delivers efficient and value-based care through choice and private competition, and has improved aspects of the Medicare program that previously failed seniors.  The Medicare program shall adopt and implement those market-based recommendations developed pursuant to Executive Order 13813 of October 12, 2017 (Promoting Healthcare Choice and Competition Across the United States), and published in my Administration's report on "Reforming America's Healthcare System Through Choice and Competition."  Doing so would help empower patients to select and access the right care, at the right time, in the right place, from the right provider.

    Sec. 2.  Policy.  It is the policy of the United States to protect and improve the Medicare program by enhancing its fiscal sustainability through alternative payment methodologies that link payment to value, increase choice, and lower regulatory burdens imposed upon providers.

    Sec. 3.  Providing More Plan Choices to Seniors.  (a)  Within 1 year of the date of this order, the Secretary shall propose a regulation and implement other administrative actions to enable the Medicare program to provide beneficiaries with more diverse and affordable plan choices.  The proposed actions shall:

      (i)    encourage innovative MA benefit structures and plan designs, including through changes in regulations and guidance that reduce barriers to obtaining Medicare Medical Savings Accounts and that promote innovations in supplemental benefits and telehealth services;

      (ii)   include a payment model that adjusts supplemental MA benefits to allow Medicare beneficiaries to share more directly in the savings from the program, including through cash or monetary rebates, thus creating more incentives to seek high-value care; and

      (iii)  ensure that, to the extent permitted by law, FFS Medicare is not advantaged or promoted over MA with respect to its administration.

   (b)  The Secretary, in consultation with the Chairman of the Council of Economic Advisers, shall submit to the President, through the Assistants to the President for Domestic and Economic Policy, a report within 180 days from the date of this order that identifies approaches to modify Medicare FFS payments to more closely reflect the prices paid for services in MA and the commercial insurance market, to encourage more robust price competition, and otherwise to inject market pricing into Medicare FFS reimbursement.

   Sec. 4.  Improving Access Through Network Adequacy.  Within 1 year of the date of this order, the Secretary shall propose a regulation to provide beneficiaries with improved access to providers and plans by adjusting network adequacy requirements for MA plans to account for:

    (a)  the competitiveness of the health market in the States in which such plans operate, including whether those States maintain certificate-of-need laws or other anti-competitive restrictions on health access; and

   (b)  the enhanced access to health outcomes made possible through telehealth services or other innovative technologies.

   Sec. 5.  Enabling Providers to Spend More Time with Patients.  Within 1 year of the date of this order, the Secretary shall propose reforms to the Medicare program to enable providers to spend more time with patients by:

   (a)  proposing a regulation that would eliminate burdensome regulatory billing requirements, conditions of participation, supervision requirements, benefit definitions, and all other licensure requirements of the Medicare program that are more stringent than applicable Federal or State laws require and that limit professionals from practicing at the top of their profession;

   (b)  proposing a regulation that would ensure appropriate reimbursement by Medicare for time spent with patients by both primary and specialist health providers practicing in all types of health professions; and

   (c)  conducting a comprehensive review of regulatory policies that create disparities in reimbursement between physicians and non-physician practitioners and proposing a regulation that would, to the extent allowed by law, ensure that items and services provided by clinicians, including physicians, physician assistants, and nurse practitioners, are appropriately reimbursed in accordance with the work performed rather than the clinician's occupation.

   Sec. 6.  Encouraging Innovation for Patients.  Within 1 year of the date of this order, the Secretary shall propose regulatory and sub-regulatory changes to the Medicare program to encourage innovation for patients by:

   (a)  streamlining the approval, coverage, and coding process so that innovative products are brought to market faster, and so that such products, including breakthrough medical devices and advances in telehealth services and similar technologies, are appropriately reimbursed and widely available, consistent with the principles of patient safety, market-based policies, and value for patients.  This process shall include:

      (i)    adopting regulations and guidance that minimize and eliminate, as appropriate, the time and steps between approval by the Food and Drug Administration (FDA) and coverage decisions by the Centers for Medicare and Medicaid Services (CMS);

      (ii)   clarifying the application of coverage standards, including the evidence standards CMS uses in applying its reasonable-and-necessary standard, the standards for deciding appeals of coverage decisions, and the prioritization and timeline for each National Coverage Determination process in light of changes made to local coverage determination processes; and

      (iii)  identifying challenges to the use of parallel FDA and CMS review and proposing changes to address those challenges; and

   (b)  modifying the Value-Based Insurance Design payment model to remove any disincentives for MA plans to cover items and services that make use of new technologies that are not covered by FFS Medicare when those items and services can save money and improve the quality of care.

   Sec. 7.  Rewarding Care Through Site Neutrality.  The Secretary shall ensure that Medicare payments and policies encourage competition and a diversity of sites for patients to access care.

   Sec. 8.  Empowering Patients, Caregivers, and Health Providers.  (a)  Within 1 year of the date of this order, the Secretary shall propose a regulation that would provide seniors with better quality care and cost data, improving their ability to make decisions about their healthcare that work best for them and to hold providers and plans accountable.

   (b)  Within 1 year of the date of this order, the Secretary shall use Medicare claims data to give health providers additional information regarding practice patterns for services that may pose undue risks to patients, and to inform health providers about practice patterns that are outliers or that are outside recommended standards of care.

   Sec. 9.  Eliminating Waste, Fraud, and Abuse to Protect Beneficiaries and Taxpayers.  (a)  The Secretary shall propose regulatory or sub-regulatory changes to the Medicare program, to take effect by January 1, 2021, and shall propose such changes annually thereafter, to combat fraud, waste, and abuse in the Medicare program.  The Secretary shall undertake all appropriate efforts to direct public and private resources toward detecting and preventing fraud, waste, and abuse, including through the use of the latest technologies such as artificial intelligence.

   (b)  The Secretary shall study and, within 180 days of the date of this order, recommend approaches to transition toward true market-based pricing in the FFS Medicare program.  The Secretary shall submit the results of this study to the President through the Assistants to the President for Domestic and Economic Policy.  Approaches studied shall include:

      (i)    shared savings and competitive bidding in FFS Medicare;

      (ii)   use of MA-negotiated rates to set FFS Medicare rates; and

      (iii)  novel approaches to information development and sharing that may enable markets to lower cost and improve quality for FFS Medicare beneficiaries.

   Sec. 10.  Reducing Obstacles to Improved Patient Care.  Within 1 year of the date of this order, the Secretary shall propose regulatory changes to the Medicare program to reduce the burden on providers and eliminate regulations that create inefficiencies or otherwise undermine patient outcomes.

   Sec. 11.  Maximizing Freedom for Medicare Patients and Providers.  (a)  Within 180 days of the date of this order, the Secretary, in coordination with the Commissioner of Social Security, shall revise current rules or policies to preserve the Social Security retirement insurance benefits of seniors who choose not to receive benefits under Medicare Part A, and propose other administrative improvements to Medicare enrollment processes for beneficiaries.

   (b)  Within 1 year of the date of this order, the Secretary shall identify and remove unnecessary barriers to private contracts that allow Medicare beneficiaries to obtain the care of their choice and facilitate the development of market-driven prices.

   Sec. 12.  General Provisions.  (a)  Nothing in this order shall be construed to impair or otherwise affect:

      (i)   the authority granted by law to an executive department or agency, or the head thereof; or

      (ii)  the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.

   (b)  This order shall be implemented consistent with applicable law and subject to the availability of appropriations.

   (c)  This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.


    October 3, 2019.



Office of the Press Secretary


“We will not rest until Americans have the healthcare system they need and deserve, a system that finally puts American patients first.” – President Donald J. Trump 

PUTTING AMERICAN PATIENTS FIRST: Since the beginning of his Administration, President Trump has put patients first so every American has the highest quality of healthcare in the world.

  • Making healthcare more affordable by lowering out of control prescription drug prices and making new affordable healthcare options available.
  • Putting patients in control of their healthcare by finally providing transparency and choice so every American can choose the care that fits their needs.
  • Unleashing American innovation to provide new treatment options for patients living with disease. 
PUTTING AMERICAN SENIORS FIRST: President Trump is taking action to protect and improve the Medicare system for America’s seniors.
  • President Trump is signing a new Executive Order to improve seniors’ healthcare and improve the fiscal sustainability of Medicare. The order will advance policies that:
    • Empower patients by giving them more plan choices, more access to telehealth and new therapies, and more time with providers.
    • Streamline the approval of therapies, while reducing obstacles to improved patient care.
    • Improve quality by implementing reforms that better link payments to value.
    • Protect beneficiaries by eliminating waste, fraud, and abuse.
    • Maximize freedom for Medicare patients and providers by reducing regulatory burdens and eliminating unnecessary barriers.
  • President Trump is putting seniors first by strengthening the Medicare system and helping ensure the program’s availability for years to come.
    • Medicare-for-All bills proposed by Democrats in Congress threaten to end the Medicare program as we know it and eliminate choice for America’s seniors.
    • Seniors are overwhelmingly satisfied with their Medicare coverage and President Trump will stand up to protect it.
  • This order will improve the ability of seniors to make choices about their insurance, helping them access the best healthcare providers and the latest innovative therapies.
PROTECTING VULNERABLE AMERICANS: President Trump is committed to protecting vulnerable American patients and families.   
  • The President has reaffirmed that protecting Americans with preexisting conditions is fundamental to his healthcare agenda.
  • President Trump is committed to ending surprise billing so no American is ever blindsided by medical bills for services they never agreed to.
    • The President has put forward principles on surprise billing to ensure patients are not taken advantage of and have the information they need to make informed decisions.
    • More than two-thirds of Americans worry about unexpected medical bills, according to a 2018 poll by the Kaiser Family Foundation.
PROVIDING AFFORDABLE OPTIONS: By lowering costs, President Trump is making sure every American can afford high quality healthcare.
  • Last year, President Trump released a historic blueprint to drive down drug prices.
  • Medicare Advantage premiums will drop next year to their lowest level since 2007, a 28 percent decrease since 2017.   
  • Medicare Part D premiums next year will be their lowest in the last 7 years.
  • Prescription drug prices fell in 2018 for the first year in nearly five decades.
  • The Food and Drug Administration approved a record number of generic drugs in 2017 and 2018 that will improve competition and drive down prices.
    • New generic drug approvals saved consumers $26 billion through the first year and a half of President Trump’s Administration.
  • The Trump Administration laid the foundation to start importing certain prescription drugs that are cheaper in other countries. 
PUTTING PATIENTS IN CONTROL: President Trump is making sure patients control their own healthcare by empowering them to make informed decisions and giving them more choices.
  • The number of Medicare Advantage plans available to our seniors has increased by nearly 1,200 over the last two years.
  • President Trump is working to expand Association Health Plans, which make it easier for employers to join together and offer more affordable health coverage to their employees.
  • Through Health Reimbursement Arrangements, employers will be able to help their employees pay for the cost of insurance that they select in the individual market.
  • The Administration expanded the availability of short-term, limited duration plans, which offer flexible coverage options and can be up to 60 percent cheaper than Obamacare plans.
  • President Trump is working to ensure hospitals cannot hide prices for their services, requiring them to publicize more data and put quality and price information into patients’ hands.
  • The President signed legislation ending “gag” clauses that prevented pharmacists from providing patients with information about lower cost options.
  • President Trump signed legislation ending Obamacare’s individual mandate penalty, which forced many Americans to buy health plans they did not want.
  • The Trump Administration is working to provide electronic health records to patients by requiring providers to give patients their data.
ENSURING HIGH QUALITY CARE: President Trump is working to promote innovative solutions and expand treatment options for Americans living with disease.  
  • President Trump launched an effort to improve kidney health and treatment in America, giving hope to the over 30 million Americans afflicted with kidney disease.
  • The Administration has significantly increased funding for opioid and pain research and is supporting research for a vaccine to prevent opioid addiction.
    • Drug overdose deaths declined nationally last year for the first time in decades.
  • President Trump signed into law $1 billion in increased Alzheimer’s research funding, reflecting his commitment to finding a cure.
  • The Trump Administration is working to encourage new, innovative approaches to treating childhood cancer.
  • President Trump signed Right to Try legislation to give terminally ill patients the ability to access potentially lifesaving cures.
  • The President launched an initiative to eliminate the HIV epidemic in the United States within 10 years.