PRESS CALL
ON THE PRESIDENT’S EXECUTIVE ORDER
ON PROTECTING AND IMPROVING MEDICARE FOR OUR NATION’S SENIORS
Via Telephone
8:05 A.M. EDT
MR. CANTRELL: Thank you, Operator. Good morning everyone, and thank you for joining today's briefing to preview President Trump's executive order on Protecting and Improving Medicare for Our Nation's Seniors.
Today's briefing will be on the record and conducted by the Health and Human Services Secretary, Alex Azar; Administrator for the Centers for Medicare and Medicaid Services, Seema Verma; and the Director of the Domestic Policy Council, Joe Grogan. If a subject matter expert is needed in the briefing, he or she will be on background, attributable to a senior administration official.
We will begin with opening remarks and, as time allows, we'll follow with question and answer. All information is embargoed until the conclusion of the call. With that, we will begin with Director Grogan.
DIRECTOR GROGAN: Thanks very much. Good morning, everyone. I'm glad you could make this call. We're very excited to share with you some of the details of President Trump's highly anticipated health speech in Florida today and the executive order that he will be announcing as part of his commitment to Medicare and his broader vision for a healthier America.
His vision for a healthier America is much wider than a narrow focus on the Affordable Care Act, which is not, at the end of the day, that many people. We're talking about 180 million people in the employer market and 60 million people in Medicare. And this President has been focusing on health issues that many administrations have ignored for decades.
He's been championing his vision and delivering on policies throughout his administration, and advancing health for all Americans. While Democrats are now focusing on Medicare for All, which will ultimately lead to "Medicare for None," the President is focused on protecting Medicare of our nation's seniors. He's delivering on his promises to lower costs, increase options, improve quality, and give patients control over their health decisions.
In that spirit, today the President will share his most recent in a series of health rollouts with seniors at The Villages in Florida. He will lay out how the Medicare executive order puts American seniors first by expanding access to the best healthcare providers and the latest innovative therapies. This executive order will improve seniors' healthcare and improve the fiscal sustainability of Medicare.
More specifically, the actions he will take today will put patients in control of their own health choices. They will ensure adequate patient access to providers by considering competitions in telehealth access and provider networks. It provides affordable options through a streamlined approval process for therapy, while reducing obstacles to improved patient care. This will protect vulnerable Americans by eliminating waste, fraud, and abuse, and will expand the use of quality and cost data to improve provider decision-making and identify undue patient risks.
And finally, this will ensure high-quality care for these Americans who deserve our great respect. This will maximize freedom for Medicare providers by reducing regulatory burdens and participation, supervision requirements, and allow providers to spend more time with patients focusing on getting them better.
The President is proud to unveil this latest in a long series of health achievements. Just a few of the President's achievements include working with Capitol Hill on achieving surprise billing relief for American patients. Medicare Advantage premiums will drop next year to their lowest level since 2007 -- a 28 percent decrease since 2017. Medicare Part D premiums, or drug benefits, will be the lowest in seven years. Prescription drug prices fell in 2018 for the first year in nearly five decades. The Food and Drug Administration has approved a record amount of generic drugs in 2017 and 2018, and this has saved consumers $26 billion through the first year and a half of the Trump administration.
He has laid the foundation to start importing certain prescription drugs that are disproportionately more expensive in the United States than overseas, and can be imported safely. And the number of Medicare Advantages available to our seniors has increased by nearly 1,200 over the last two years. He's expanding association health plans, making it easier for employers to join together and offer more affordable health coverage to their employees.
He's expanding health reimbursement arrangements, allowing employers to find creative ways to give healthcare to their employees, and empowering employees to buy the best healthcare available to them.
He's expanding short-term, limited duration health plans, which give more flexible options for American patients who are priced out of the failed Obamacare plans.
He's working with hospitals to make sure they cannot hide prices for their services, with a major transparency initiative that will drive down costs for American patients and providers.
He's ending gag clauses that prevent pharmacists from providing patients with information about lower-cost options.
He eliminated the individual mandate penalty. We're working on interoperability for electronic health records, which should be done before the end of the year.
He's improved kidney health and treatment in America, addressing problems with that program that have not been addressed since it was created by Richard Nixon in the early 1970s.
And, of course, we have focused on opioid abuse and we've driven down opioid overdose for the first time in decades.
President Trump recently just signed a law to increase Alzheimer's research funding. This week, he signed a bill to increase autism services and research. And, of course, we're focusing on fighting pediatric cancer, ending HIV transmission in 10 years, and implementing the Right to Try legislation that he signed early in his administration.
With that series of achievements, I want to turn it over to the Secretary of Health and Human Services, Alex Azar.
SECRETARY AZAR: Thanks, Joe. I want to lay out for all of your briefly why the President is so committed to defending and improving Medicare and how this commitment fits into his broader healthcare vision. President Trump has a particular vision for healthcare -- a system that's affordable, personalized, and patient-centric; a system that puts you in control, provides peace of mind, and treats you like a human being, not a number.
That's the vision we've been working toward at HHS, under his administration.
The President has made some clear promises on healthcare, and he'll reinforce those in his speech today. He will always protect vulnerable Americans, including those with preexisting conditions, and he will deliver all American patients the affordability they need, the options and control they want, and the quality they deserve.
This summer, I laid out three specific platforms on which we're working to deliver the President's vision. And the healthcare successes Joe just listed all fit within that framework.
First, we're reforming how Americans finance their care, by opening up new affordable options under the ACA while working towards a fiscally sustainable safety net, which protects vulnerable Americans and ensures no American is going to lose their house over healthcare expenses.
Second, we're delivering better value in healthcare through delivering transparency around price and quality; unleashing health IT and data; paying for outcomes; removing regulatory burdens; lowering drug prices; and accelerating drug and device approval and reimbursement.
Third, we're tackling particular, impactable health challenges, including the HIV/AIDS epidemic, kidney disease, the opioid crisis, rural healthcare, maternal health, social determinants of health, and others that Joe just mentioned.
This is the most comprehensive vision for healthcare that I can recall any President putting forth. We've already delivered action on every front I mentioned, but there's more to come.
Today's executive order particularly reflects the importance the President places on protecting what works in our system and fixing what's broken. Sixty million Americans are on traditional Medicare or Medicare Advantage. They like what they have, so the President is going to protect it. But he's also going to make it better, more affordable, higher quality, with more options and more control.
Today's executive order makes very clear the President's commitment to protecting and improving Medicare. He has the same commitment to the private insurance system that covers most Americans. The President's commitment stands in sharp contrast to proposals that would destroy these two pillars of our healthcare system. He's dedicated to protecting Medicare and private insurance, and he's dedicated to making them better.
Looking at the facts and results that Joe laid out, it's fair to say that seniors' Medicare experience has never been better than it is under President Trump. That's what it looks like to bring American patients the affordability they need, the options and control they want, and the quality they deserve. That's the President's vision, and that's what we're going to keep delivering.
I now want to hand things over to Administrator Verma to discuss some more details on the EO and what we've done to strengthen Medicare.
ADMINISTRATOR VERMA: Thank you, Secretary Azar and Director Grogan.
President Trump continues to be the great protector of the Medicare program. The strides we have taken in strengthening Medicare and, by extension, the entire system, simply would not be possible without his steadfast leadership and unshakeable commitment to our nation's seniors.
As the head of the Medicare program, I am deeply concerned about proposals to eviscerate Medicare by indiscriminately stripping private health insurance from 180 million more Americans and placing them into the system. Proposals like Medicare for All, as well as the public options, are not just impractical, they are morally wrong because they would demote American seniors to little better than second-class status.
The President's executive order on Protecting And Improving Medicare for our Nation's Seniors reflects precisely the opposite approach. We made a promise to seniors who have paid into this program their entire lives.
This administration recognizes that it's immoral to default on that promise in pursuit of a fanciful pipedream that will increase taxes, ration care, and ruin the program for everyone. As Joe said, Medicare for All is “Medicare for None."
Under the President's leadership, we are improving the Medicare experience for current beneficiaries while strengthening and protecting it for future generations. And this builds on our current successes.
Under President's Trump order to cut the red tape, we launched Patients Over Paperwork in 2017 to eliminate outdated and burdensome regulations. To date, we're saving almost $6 billion and 40 billion burden hours over the next decade. And the President's executive order envisions us going even further. That means addressing issues like prior authorization and continuing to remove unnecessary regulations that get in between patients and their doctors. By getting government out of the way, we are allowing our nation's doctors to spend more time with seniors to give them high-quality care.
We will issue rules that expand seniors' choices and puts them in control of their own care. For example, they will have more options on where they go to obtain care, whether it's a doctor's office, a hospital, or a surgery center -- changes that will give them more affordable options.
To help seniors take advantage of their newfound choices, we are full steam ahead on our cutting-edge e-Medicare initiative, which will empower them with new online tools that will allow them to shop around for the best deal.
We are also working to make sure seniors have access to their medical information. And this will allow them to actively engage in their own care and make it easier for their doctors to have a complete medical history.
President Trump is committed to making sure that our seniors have access to the latest technologies and breakthrough treatments. Too often, government lags far behind the private sector in getting seniors access to the latest innovation. We will implement regulations to minimize time and steps between FDA approval and CMS coverage decisions for these lifesaving technologies.
We're already paying for new technologies at record rates, but the President wants to improve the process so that seniors can have access to the latest treatments sooner. This executive order is built on our record of demonstrated success. Secretary Azar mentioned the recent price reductions in Medicare Advantage, and I want to provide some additional detail on that point.
Thanks to President Trump's leadership, we removed burdensome regulations and increased flexibility for Medicare Advantage plans. Those new policies have translated into new choices for consumers. Over 1,200 new plans are being offered. And the critical point to remember with these price reductions is that there are companies buying new and better benefits. Take one example: We are now covering the latest technology through telehealth, which is a particularly important benefit for seniors in rural areas. Additionally, we are expanding opportunities for seniors to choose Medicare Advantage plans that are providing new supplemental benefits or extra benefits that are tailored to their specific needs to help them maintain their health, independence, and improve their quality of life.
In 2020, about 500 plans will provide approximately up to 2.6 million Medicare Advantage enrollees with access to expanded primarily health-related supplemental benefits, such as adult daycare services or caregiver support services.
In short, the Trump administration is infusing Medicare with more convenience, more affordability, and more benefits. These changes will not only serve the 60 million Medicare beneficiaries, but cause a ripple effect across the entire healthcare system, lowering costs and increasing quality of care for all Americans.
I couldn’t be prouder to be a part of this historic effort to strengthen and protect the Medicare program. Thank you.
MR. CANTRELL: Thank you all. Operator, we will now take some questions.
Q Hi. This is Kimberly Leonard from the Washington Examiner. You mentioned improving the financial sustainability of traditional Medicare, which I know that's something that conservatives and Republicans are concerned about.
What specific part -- how exactly will you be doing that through the executive order? Thank you.
ADMINISTRATOR VERMA: I think there's many things in the executive order. Even just reducing burdensome regulations, that's a savings to the entire system. The changes that we've made that are resulted in lower Part D premiums -- because the federal government also pays half of those premiums, those are savings that go to taxpayers. A lot of the changes that we've made and will continue to make around site-neutral payments, those also have a direct benefit to federal taxpayers as well.
So there's a lot of things here that, you know, will not only improve quality of care and the experience for beneficiaries; they'll result in direct savings to taxpayers as well.
Q Good morning. This is Ben Gittleson from ABC News. Thanks for doing this. The White House said, on its schedule Sunday that referred to today’s executive order as an executive order "Protecting Medicare from Socialist Destruction." But now it's being called an executive order "Protecting and Improving Medicare for our Nation's Seniors." So, I was just curious: What was the thinking behind changing the name?
DIRECTOR GROGAN: I don't know that we did change the name, to be completely honest with you. This is Joe Grogan. You know, we are contrasting this administration's commitment to traditional Medicare and modernizing the program for the benefit of seniors opposed to the vision for Medicare as a one-size-fits-all, single-payer system, which would destroy the program and not protect seniors. So, the two are not in opposition. We're protecting the program for our nation's seniors and protecting it from a single-payer socialist vision of the program.
Q Hello. This is Donna Young from S&P Global News. I had a question on what Administrator Verma said about implementing regulations to reduce the time from FDA approval to CMS paying. Is that actually part of this executive order or are you talking about the earlier actions? Thanks.
ADMINSTRATOR VERMA: I think that the executive order will direct the agency to improve that process, but it already also builds on the current efforts that we've made around increasing access to innovation for seniors. I think we've done -- we've taken a number of historic steps, even around diabetic pumps.
I think, recently, with our proposals in our Medicare rule that just came out this year, there was a proposal to increase the NTAP payments. There were some changes to make it easier for breakthrough devices to get new technology add-on payments. So there's already been a number of historic achievements in that area.
And the President's executive order will ask the agency to go further with this process to reduce the amount of time between FDA approval and (inaudible) decision, coding, and payment through the Medicare program.
Q Hi. This is Rachel Roubein with Politico. I was curious if you guys could detail what exactly the executive order will direct agencies to do on Medicare Advantage. I know there are some things in the 2019 and 2020 (inaudible) on social determinants of health, supplemental benefits. Will the executive order ask agencies to go further on that? And on telehealth as well?
SECRETARY AZAR: Sure. So, this is Secretary Azar. So, the executive order will require that I propose a regulation and implement other administration actions that would enable the Medicare Advantage to provide beneficiaries with more diverse and affordable plan options.
There are three key elements that have to be in that. The first is to encourage innovate Medicare Advantage benefit structures and plan designs, including changing regulations and guidance that reduces barriers to obtaining Medicare and medical savings accounts, and that promote innovations and supplemental benefits and telehealth services.
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.
And third, ensure that, as much as we can, our Fee-for-Service Medicare program is not advantaged or promoted over Medicare Advantage with respect to its administration.
In addition to the telehealth aspects that are in that -- that you asked about telehealth -- there’s another element of the executive order dealing with improving access through network adequacy. You know, we review Medicare Advantage plans for network adequacy. And part of that will include now being able to factor in the availability of telehealth services or other innovative technology as part of providing enhanced access through MA plans.
Q Hey, thank you for taking my question. Ricardo Alonso-Zaldivar with AP. And going back to what Secretary Azar just said, can you please spell out how you would make sure that Fee-for-Service Medicare is not advantaged or promoted over Medicare Advantage? Would you change the sign up for Medicare in any way?
SECRETARY AZAR: Well, Ricardo, we’re going to look at all of that. So the executive order commissions us to examine all practices, regulations, guidance to just make sure 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.
So we’ll be looking at all of those issues: how does the enrollment process work when new people come in; how the annual enrollment process work; are we providing adequate information through the various plan-finder tools to ensure people can make informed choices, make sure there’s no financial disincentive to being an MA versus Fee-for-Service. So really, across the board that’s -- the executive order is the initiation of the process now of examining all of that, Ricardo.
ADMINISTRATOR VERMA: And to build on what the Secretary said, President Trump’s order is not just around Medicare Advantage. That’s one component of it, but he’s directing the agency to take action across the board, which is going to benefit seniors that participate in the traditional program, as well as Medicare Advantage.
Some of the changes that we’re going to make around regulations, you know, in terms of the technology and making that available -- especially the pieces that we just talked about with innovation, those, in particular, would impact individuals that are in the Fee-for-Service program.
From our perspective, we want to make sure that seniors have choices and the information that they need to make an informed decision.
SECRETARY AZAR: Yes, it’s a -- and to the point that the Administrator just made that we have not mentioned: A very exciting part of the executive order requires that we propose reforms to the Medicare program that allow providers to practice to the top of their licensure.
You know, we have -- there are artificial restraints in the Medicare program the prevent people like nurse practitioners, PAs, et cetera from really maximizing the full value and training and licensure that they have through supervision requirements or other artificial limitations.
And the President will be unleashing them to practice to the maximum extent of their licensure, which should really enhance access to care; enhance provider availability for all Medicare beneficiaries, including in Fee-for-Service; and really help, especially with the rural healthcare crisis.
MR. CANTRELL: Operator, we have time for one last question, please.
Q Hi, this is Shira Stein with Bloomberg Law. You mentioned that you’re going to address the issue of prior authorization. How exactly are you planning to do that through this executive order?
ADMINISTRATOR VERMA: Well, something that, you know, as -- in 2017, we started our Patients over Paperwork initiative, and that was a response to the President’s initiative around cutting the red tape and reducing regulations across the entire federal government. And we did a series of listening sessions. We’ve put out a couple of different RFIs. And across the board, that is the one issue that has come up time and time again from providers.
And so we’re actively engaged in that issue. We’re continuing to have listening sessions. And right now our team is working on that and we can expect to see more action from the agency on that issue.
MR. CANTRELL: Thank you everyone. This will conclude our call. Again, remarks were on the record. As always, you can direct all further questions to the White House Press Office. Thank you everyone for joining this morning.
END 8:30 A.M. EDT |
President Trump:
