Payer Roundup—Trump rails against Medicare-for-all; Medicare paying nursing facilities more for rehabilitation

President Trump said Medicare-for-all is "extreme, anti-senior, anti-choice and anti-consumer." (Flickr/Gage Skidmore)

Trump publishes op-ed against Medicare-for-all 

President Trump published an opinion piece in USA Today on Wednesday arguing that a single-payer healthcare bill “threatens America’s seniors.” 

S. 1804, which was introduced by Sen. Bernie Sanders, I-Vt., with sixteen Democratic co-sponsors in September 2017, is commonly known as “Medicare-for-all.” The proposal has become more popular in recent months as progressive Democrats gain steam leading up to the midterm election. 

The bill is “extreme, anti-senior, anti-choice and anti-consumer” because it would eliminate private coverage, including Medicare Advantage, Trump wrote. He argued it would lead to longer wait times, rationing of services and reduced choice. 


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“I am committed to resolutely defending Medicare and Social Security from the radical socialist plans of the Democrats … this is a fight we must win,” the president concluded. 

Senator Sanders contested Trump’s claims. In a response on his website, he said the bill lowers costs and provides seniors with benefits that Medicare currently does not cover. In addition, he said, it allows patients to see any doctor, not just in-network ones. (Trump article/Sanders response

Nursing facilities shuttling patients to costly rehabilitation during their final days

Elderly patients in nursing facilities are spending more and more time in rehabilitation treatment as they near the end of life, said a recent study from the University of Rochester. 

The percent of those patients who spent 12 or more hours per week—an amount Medicare classifies as “ultrahigh”—in physical, occupational, or speech therapy increased 65% between October 2012 and April 2016, the study said. A significant percentage of patients had the most rehabilitation during their final week of life. 

For-profit facilities were more than twice as likely to use a high amount of therapy than not-for-profit ones, the study said. 

Medicare pays nursing facilities about $560 per patient per day for “ultrahigh” rehabilitation services. In contrast, it pays a rate of $325 for a “low” amount, which it defines as less than 2.5 hours per week. These findings could indicate nursing facilities, especially for-profit ones, send patients at the end of life to more therapy to maximize revenue, experts say. (Bloomberg article

Resolution to halt short-term plans fails in Senate

A bill that would overturn the executive order expanding short-term (or “junk”) insurance plans did not pass in the Senate on Wednesday. 

The joint resolution, S.J. Res. 63, received 50 “yea” votes on the Senate floor from 49 Democrats and one Republican, Susan Collins of Maine. The remaining members, all Republicans, voted “nay.”

“It’s disappointing that too many Senate Republicans failed to keep their promise to protect people with pre-existing conditions from being denied coverage,” wrote Sen. Tammy Baldwin, D-Wis., who introduced the bill, on her website. 

However, she pledged, “I will continue my fight to protect the guaranteed health care protections that millions of Americans depend on because the people of Wisconsin did not send me to Washington to take their health care away.” (Release

Poll finds Ohioans of all political leanings support Medicaid 

68% of Ohio adults view Medicaid favorably, including 84% of Democrats, 62% of independents and more than half—57%—of Republicans, according to a recent poll from Interact for Health, an advocacy organization that aims to improve health in the Cincinnati area. 

In addition, the uninsured rate among Ohio adults is 9%, slightly below the national rate of 13%. Only 7% of Ohio adults have gone without coverage at some point over the last year. 

“As policymakers in Ohio consider healthcare policy and its related costs, it can be helpful to understand attitudes about health-related programs, specifically Medicaid,” Interact for Health said. Although the survey didn’t ask about the state’s Medicaid expansion specifically, recent comments by Ohio’s Republican leaders about it have attracted attention. 

Governor John Kasich, whose term is coming to a close, has been traveling throughout the state touting the expansion’s success. Under his leadership, the Ohio Department of Medicaid released a report outlining the expansion’s benefits earlier this year. 

One of his potential replacements, Ohio Attorney General Mike DeWine, is among several Republican candidates this election season who has warmed up to Medicaid expansion over time. (Poll results

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