Republicans blasted Obama’s use of an obscure Medicare law. Now Trump’s using it on $200 drug coupons — and the GOP is silent

“Trump’s plan is to ship seniors $200 prescription drug coupons in the coming weeks, a massive, $6.6 billion initiative that he announced less than six weeks before Election Day. He is relying on the same authority that Obama used in 2010 to bolster a more expensive, albeit less outwardly political, plan to direct bonus payments to high-performing insurance companies ahead of his own reelection campaign.

[..] Both the Obama and Trump controversies surround so-called demonstration authority, a power granted to the White House to test whether changes to Medicare to make the program run smoother or save money.

Obama used that authority to change the bonuses for high-performing insurers that contract with Medicare. The plan, which was meant to test whether “stronger financial incentives and investments” would lead plans to offer better quality insurance coverage, would have doled out lucrative bonuses to 90% of private insurers.

Republicans saw it as an attempt to insulate seniors from spiking insurance premiums before an election. They argued that the Obama administration was robbing money from a different health program to prop up the Affordable Care Act and doling out the bonuses to make sure seniors didn’t feel the brunt of the cuts before the election.

“An honest way to come to the Congress is: Look, we screwed up, we would destroy Medicare Advantage if we didn’t bail it out, so we came up with a scheme to bail it out, that’s what you did,” said Rep. Darrell Issa (R-Calif.), who led the Republican investigation into the project.

[..] Both the GAO [Government Accountability Office] and lawmakers noted that the absence of a control group made it difficult to conduct an experiment to measure the program’s effectiveness. The GAO ultimately found that the Obama administration likely exceeded its authority and recommended the demonstration be canceled.

“There was clearly oversight following that demonstration,” said Jon Blum, the former Obama administration official hauled before Congress after the Obama demonstration. Blum added that he believed many of the criticisms waged at the Obama demonstration, like the lack of a control group, likely could plague the Trump ploy, too.

Trump’s plan is more brazen. It’s not clear how the Trump administration might test whether the payments had their intended goal if all seniors in Medicare are getting payments — or what the administration is planning to test at all.”

Full article, Florko N and Facher L. Stat News 2020.9.25