Trump Blasts Democrats on ‘Socialist’ Medicare for All

Plus, would a Warren-style wealth tax kill the economy? By Yuval Rosenberg and Michael Rainey Trump Blasts Dems on ‘Socialist’ Medicare for All President Trump on Thursday signed an executive order to expand private Medicare Advantage plans, bashing Democratic proposals for a government-run Medicare-for-All system as socialism and positioning himself as a defender of private insurance and the existing health care program for seniors. "Medicare is under threat like never before," Trump said in a campaign-style [speech]( delivered at The Villages, a heavily Republican retirement community outside Orlando, to an audience that occasionally broke into chants of “four more years.” “They want to raid Medicare to fund a thing called socialism,” he said of Democrats, continuing a key theme of his re-election campaign. Behind him, the backdrop read "GREAT HEALTHCARE FOR YOU." Trump defended his administration’s record on health care and pledged to protect patients with pre-existing medical conditions, despite his administration’s efforts to have the Affordable Care Act, which includes such protections, ruled unconstitutional. The president also promised to end surprise medical bills and to allow the importation of lower-priced prescription drugs from countries including Canada. And he vowed to deliver a “fantastic” Obamacare replacement plan if he’s re-elected next year and Republicans win control of both houses of Congress. A focus on Medicare Advantage: Trump then signed an [executive order]( to expand supplemental benefit options and telehealth services under Medicare Advantage, an increasingly popular alternative to traditional Medicare that’s administered by private insurers. Enrollment in Medicare Advantage plans has nearly doubled over the past decade, rising to 22 million, or just over a third of those covered by Medicare overall. Medicare Advantage critics say the plans boost private insurers at taxpayer expense. The Government Accountability Office reported in 2016 that the plans [overbilled]( the government by billions of dollars, The Wall Street Journal notes. Trump’s executive order “also appears to include a grab bag of proposals, including removing ‘unnecessary regulations that get in between patients and their doctors,’ new online tools to help people choose their Medicare plans, quicker access to ‘breakthrough treatments,’ and better access to medical information, according to Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, who spoke to reporters in a briefing call Thursday,” NPR [reported](. The order also says it seeks 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.” The order had been titled "Protecting Medicare from Socialist Destruction," but was renamed, "Protecting and Improving Medicare for Our Nation's Seniors." “We are making your Medicare even better,” Trump told the crowd. “As long as I’m president, no one will lay a hand on your Medicare benefits.” Can Trump find a health-care message? The Trump administration’s [approach to health care]( includes efforts to push alternatives to Obamacare and give more control to states. But the administration has struggled to push through a number of substantive proposals, and some of the actions Trump touted Thursday have had limited success. Democrats rode a health care message to retake control of the House in 2018 and they’re sure to hammer Trump’s efforts to dismantle Obamacare as part of the 2020 campaign. “President Trump’s announcement today is nothing more than a thinly veiled effort to disguise his Administration’s dismal record on health care and protecting seniors,” House Majority Leader Steny Hoyer said in a statement Thursday. “This executive order is an admission that the President and Republicans are worried that American voters can see through their health care ploys.” Without an overarching reform proposal or progress on legislative proposals in Congress, health care may remain a vulnerability for Trump — hence the focus on protecting the current system and defending Medicare as it exists now. “The speech is a part of the White House's efforts to put Trump's health care agenda at the forefront of his reelection campaign, hoping to attract swing voters uncomfortable with his attacks on the Affordable Care Act or a fully government-run health care system championed by two of his chief 2020 Democratic rivals, Sens. Bernie Sanders and Elizabeth Warren,” Politico’s Rachel Roubein [writes](. But Trump veered away from health care multiple times during his speech — revisiting the 2016 election, commenting on Elizabeth Warren’s surge in the Democratic presidential primaries and accusing Democrats of pursuing impeachment “because they know they can't beat us fairly" — providing another reminder of just how difficult it may be for him to keep focused on a policy area voters say matters greatly to them. Still, Trump could yet find a winning message on health care. The Wall Street Journal’s Stephanie Armour [reports]( that Trump believes “his focus on lowering costs will appeal more than Democrats’ pledge to expand coverage.” And a steady drumbeat of attacks criticizing Democrats for supposedly trying to take away Medicare could still resonate with seniors. “I don’t think it’s inherently a threat to the integrity of the program, but I can see the elderly may be nervous about anything that changes the program,” David Blumenthal, president of the Commonwealth Fund, told the Journal. Would a Warren/Sanders Wealth Tax Kill the Economy? As Democratic presidential candidates debate a variety of new social programs, from universal health care to free higher education, Elizabeth Warren and Bernie Sanders are calling for a wealth tax to help fund some of their most ambitious plans. Such a tax has political purposes as well, aiming to chip away at rising inequality and the economic power of the superrich, who have claimed the lion’s share of growth in recent years. Warren has proposed a 2% tax on household wealth above $50 million, rising to 3% for billionaires. [Sanders’ plan]( is more aggressive, applying a 1% tax to net worth over $32 million, with the rate increasing steadily until it tops out at 8% for those worth more than $10 billion. But is a wealth tax a viable idea? And what would it do to the economy? What critics say: Although a wealth tax is popular with the public on a bipartisan basis, the idea is nevertheless controversial, and there are sure to be legal challenges to any effort to impose one. Constitutional issues aside, plenty of economists and business leaders insist that taxing capital is a bad idea, one that threatens the efficient operation of the economy. “You’re going to completely disincentivize capital investment, which is going to be very, very bad for economic growth,” said Treasury Secretary Steven Mnuchin last month, according to a [New York Times piece]( this week examining the issue. Some centrist economists agree. The Times quotes Larry Summers, President Obama’s former Treasury Secretary, who co-wrote an article claiming that a wealth tax “would undermine business confidence, reduce investment, degrade economic efficiency and punish success in ways unlikely to be good for the country or even to be appealing to most Americans.” Critics also argue that the rich will likely be able to evade any wealth tax Democrats try to impose, thanks to the lawyers and accountants they can pay to create workarounds for virtually any tax regimen. Criticizing wealth taxes on both an economic and practical basis, economist N. Gregory Mankiw, who led President George W. Bush’s Council of Economic Advisers, told the Times that, “On the one hand it’s a bad policy, and then the other thing is it’s a feckless policy.” What supporters say: “Don’t believe the scaremongering,” [says David Leonhardt]( of The New York Times, who argues that there is reason to believe a wealth tax would actually accelerate economic growth. Reducing inequality, which stands at [record levels]( in the U.S., via a wealth tax would free up funds that “are held by a tiny slice of people, who aren’t using the resources very efficiently,” Leonhardt wrote Wednesday. Gabriel Zucman, the University of California at Berkeley economist who has done much of the intellectual legwork underlying the Democratic tax proposals, told the Times that the tax would have a positive, though modest, effect on economic growth by spurring innovation and competition. Steve Wamhoff, director of federal tax policy at the liberal Institute on Taxation and Economic Policy, cited the public investments that could be financed with revenues from the wealth tax, providing the economy with a much-needed boost. “Industrialized nations with thriving economies all over the world collect far more in tax revenue and invest far more in public goods than we do,” Wamhoff [wrote]( Wednesday. “If we need to raise revenue, taxing the rich is a logical place to start given exploding income inequality and wealth inequality.” Addressing the potential problem of tax evasion, Gene Sperling, who advised Presidents Clinton and Obama on economic matters, [argued]( last summer that “Tax evasion is a solvable policy failure not an unsolvable act of God … there’s no reason to assume one can’t develop fair, common sense rules to deal with” the technical difficulties involved in applying a wealth tax. The bottom line: Given the range of opinion among economists and policy experts on the issue, it’s safe to say that we don’t really know how a wealth tax would affect the economy. Like much else related to the tax code, the argument over the wealth tax is inevitably political, with much depending on your basic assumptions and preferences. 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