If President Donald Trump was seeking a place to escape the ever-ringing static of impeachment to bask in unquestioned adulation, he found it at The Villages Thursday.
The Villages, an affluent retirement community near Ocala, is rapidly gaining stature as a “must-visit” Central Florida GOP stronghold for Republicans seeking state and national office.
The Villages is also the epicenter of a three-county sprawl of about 300,000 people who are enrolled in some form of Medicare, according to the Centers for Medicare & Medicaid Services (CMMS).
Therefore, Trump’s appearance at the Sharon Morse Performing Arts Center in Spanish Springs Town Square – accompanied by Florida Gov. Ron DeSantis – to discuss changes that could affect 22 million Medicare recipients nationwide could not have been before a more appreciative red, white and gray constituency.
Trump signed an executive order that broadens Medicare Advantage’s private insurance option, which he said will encourage privatization while protecting people with preexisting conditions, maintain affordability, preserve provider choice and fight the opioid epidemic.
"In America, we believe in freedom and liberty, not government domination and government control," Trump said before signing the executive order. "We are going to expand our growing economy to make retirement easier, better and far more secure."
The Trump administration says this will encourage Medicare Advantage to become more personal, affordable and “patient-centric.”
Medicare Advantage, the private insurance option under Medicare, allows enrollees to choose between private healthcare companies like UnitedHealth Group and Humana.
It offers enrollees savings on premiums and an annual limit on out-of-pocket costs while providing “one-stop shopping” for comprehensive plans by major insurers.
Among trade-offs is Medicare Advantage enrollees must accept limits on choices of hospitals and doctors, and prior insurer approval for certain procedures.
Trump’s order directs the U.S. Heath & Human Services Department to examine current policies and practices to determine if there is a systemic bias to ranking traditional Medicare ahead of the private Medicare Advantage option.
The order also expands services that can be offered by private plans and directs regulators to find more ways for seniors to financially benefit from plans that provide cost-efficient service.
The executive order lays out months of work for HHS and other federal agencies before it will produce actionable results. Upgrades in telemedicine and Medicaid/Medicare payment programs must be enacted to achieve Trump’s aspirational goals.
Like “traditional” Medicare, Medicare Advantage is a federal health insurance program for adults over 65 and young people who meet federal disability requirements.
Many Advantage plans bring together Medicare components – hospital care, doctor visits, prescription drug coverage – into a single package that can also offer additional benefits such as dental and vision coverage.
“Traditional” Medicare pays by the service while under the executive order, Medicare Advantage would give insurance companies a lump sum per person annually.
Another difference between the new Medicare Advantage and the former program is now beneficiaries are restricted to a defined network of providers like an HMO or preferred provider organization.
Trump said his plan would directly cut costs by reducing expensive emergency room visits by uninsured patients. In turn, lower cost would help Medicare Advantage’s fiscal stability.
"It is about getting better when you're sick," Trump said. "It's about improving your well-being and getting the treatment you need."
The goal is to reduce the cost of premiums and deductibles for overall doctors visits, the president said.
"We are going to protect Medicare for you, for everyone in The Villages, for every senior across this magnificent land," he said. "You are going to be protected."