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October 11, 2018

Trump bashes Medicare-for-All in USA Today. (But fact-checkers argue he made these 5 misleading claims.)

Daily Briefing

    President Trump in a USA Today op-ed published Wednesday strongly denounced so-called "Medicare-for-All" legislation championed by legislators such as Sen. Bernie Sanders (I-Vt.), arguing that such a proposal would "end Medicare as we know it"— but fact-checkers are pushing back on many of his claims.

    What's the cost of Sanders' 'Medicare-for-All' plan? About $33T over a decade, new analysis finds

    Trump slams 'Medicare-for-All'

    In the op-ed, Trump criticizes "a new legislative proposal," which he writes is "dishonestly called Medicare-for-All," that Democrats across the country have been "uniting around."

    Though Trump didn't specify a particular bill, he appears to be referencing Sanders' Medicare-for-All legislation, which Sanders unveiled last year with the backing of 16 Democratic senators. The proposal essentially would eliminate private health insurance and replace it with a government-run health system by expanding Medicare to cover all U.S. residents. Since then, Democratic lawmakers have released several other universal health care proposals, although they are not as far-reaching as Sanders' bill.

    The 5 claims that fact-checkers find dubious

    Fact-checkers at various major news outlets argued that several claims in Trump's op-ed were ill-supported.

    Claim #1: "Throughout the year, we have seen Democrats across the country uniting around a new legislative proposal that would end Medicare as we know it and take away benefits that seniors have paid for their entire lives."

    Linda Blumberg of the Urban Institute told PolitiFact that Trump's statement is a "horrible mischaracterization of the proposal." She explained that Sanders' "Medicare for All" proposal would actually expand Medicare coverage to include dental, vision, and hearing aids.

    Glenn Kessler in the Washington Post's "FactChecker" similarly wrote, "On paper, at least, the Sanders plan would improve benefits for seniors, not take them away."

    Claim #2: "By eliminating Medicare as a program for seniors, and outlawing the ability of Americans to enroll in private and employer-based plans, the Democratic plan would inevitably lead to the massive rationing of health care."

    Trump's argument, according to fact-checkers, includes an important element of truth: Sanders' plan would in fact end private and employer-based plans.

    Kessler argues, however, that the "rationing" argument goes too far, as it is difficult to know how a transition to "Medicare-for-all" would affect access to health care services.

    In an analysis of Sanders' plan by the Mercatus Center of George Mason University, Charles Blahous wrote, "It is impossible to say precisely how much the confluence of these factors would reduce individuals' timely access to health care services, but some such access problems almost certainly must arise."

    Claim #3: "Indeed, the Democrats' commitment to government-run health care is all the more menacing to our seniors and our economy when paired with some Democrats' absolute commitment to end enforcement of our immigration laws by abolishing Immigration and Customs Enforcement. That means millions more would cross our borders illegally and take advantage of health care paid for by American taxpayers."

    According to Politifact, Trump's claims here are misleading, as immigrants who enter the country illegally are ineligible for Medicare, non-emergency Medicaid, and subsidies to purchase health insurance on the exchanges. Such immigrants may, however, be eligible for uncompensated emergency care, because hospitals in the United States are not able to turn away patients in need of emergency medical assistance.

    Further, according to Associated Press, "Sanders' legislation calls for 'inhibiting travel and immigration to the United States for the sole purpose of obtaining health care services.'" Meanwhile, a separate "Medicare-for-All" proposal introduced in the House "calls for reimbursement arrangements with other countries or self-pay for foreigners scheduling surgeries at U.S. hospitals."

    Claim #4: "As a candidate, I promised that we would protect coverage for patients with pre-existing conditions and create new health care insurance options that would lower premiums. I have kept that promise, and we are now seeing health insurance premiums coming down."

    Several fact-checkers noted that the Trump administration currently is arguing in court that the Affordable Care Act's pre-existing conditions protections should be struck down as part of a broader constitutional challenge to the law. So far, the administration has not offered a plan to replace those protections if they are struck down in court.

    Claim #5: "[T]he Democratic proposal would establish a government-run, single-payer health care system that eliminates all private and employer-based health care plans and would cost an astonishing $32.6 trillion during its first 10 years."

    Trump's quote appears to cite a Mercatus Center of George Mason University study of Sanders' health care plan, which projected that federal spending under the plan would rise by $32.6 trillion over a 10-year period ending in 2031.

    While Axios' "Vitals" described Trump's quote as "an accurate summation" of the study, "Vitals"argued that Trump omitted an important factor: While taxpayers likely would pay higher taxes under Sanders' plan, they would pay less than they do under the current system in premiums and out-of-pocket costs.

    As such, total health care spending would actually fall by $2 trillion, according to the study, and some patients would pay less overall (Trump, USA Today, 10/10; Kessler, "Fact-checker," Washington Post, 10/10; Alonso-Zaldivar, Associated Press, 10/9; Greenberg et al., PolitiFact, 10/10).

    Medicare 101: Cheat sheets for Parts A through D

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