The Trump Administration Treats Seniors as Expendable

Holding onto her cane, a patient waits for a ride after a doctor's appointment in Los Angeles.

Amid a pandemic in which seniors have been disproportionately infected and killed, the Trump administration and its allies continue to fail at protecting seniors’ health care access. By downplaying the COVID-19 pandemic and failing to act, and discounting the impact of the coronavirus on seniors with preexisting conditions, the Trump administration and its allies are letting down older adults and those who love them. Meanwhile, the administration continues to push for repeal of the Affordable Care Act (ACA), which would cause seniors’ out-of-pocket premiums and prescription drug costs to soar, and to punt on prescription drug pricing reform. In the middle of a historic health crisis, the Trump administration has left seniors behind.

The Trump administration’s failed coronavirus response disproportionately harms seniors

The Trump administration “intentionally downplayed” the severity of the COVID-19 pandemic and failed to mount an adequate response to contain the spread of the virus. Seniors are at a heightened risk for severe and life-threatening coronavirus complications, meaning that the administration’s failed response disproportionately harms them. More than 160,000 seniors—those ages 65 and older—have died from the coronavirus or related complications, making up nearly 80 percent of all coronavirus-related deaths in the United States. President Donald Trump has taken this disparity as a sign that the coronavirus is no cause for concern, rather than as a crisis for older people and their loved ones.

In fact, the president’s support for the ideas underpinning a “herd immunity” strategy—in which the administration would continue to allow the virus to spread unabated and which downplays risk for groups such as the elderly—demonstrates in extreme terms just how little the administration prioritizes seniors’ health. Such a strategy would diminish the value of the lives of the elderly, disabled, and others who experience coronavirus complications, as well as dismiss the countless known and unknown long-term health effects of COVID-19 on survivors. Herd immunity has also been dismissed by infectious disease experts—including  Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases—as “total nonsense.” Fauci has explained that it is nearly impossible to protect the vulnerable with this strategy, as it “is risky and you’ll wind up with many more infections of vulnerable people, which will lead to hospitalizations and deaths.” Furthermore, the Infectious Diseases Society of America and an international group of top medical specialists in the acclaimed medical journal The Lancet have sharply opposed the pursuit of herd immunity.

Furthermore, the Trump administration continues to irresponsibly tout experimental treatments such as hydroxychloroquine and Regeneron’s monoclonal antibody cocktail with little evidence of their safety or efficacy, putting seniors at high risk of complications. False and unproven claims about vaccines and therapeutics—including a baseless declaration that Regeneron’s cocktail is a cure—spread misinformation and downplay safety concerns. Because seniors are more likely than younger people to experience adverse drug events, pushing medications without a rigorous testing and approval process can compound the harm experienced by seniors during this crisis.

ACA repeal could cause seniors’ premiums and prescription drug costs to soar

As the coronavirus pandemic rages on, the Trump administration has doubled down on its attempts to repeal the ACA, which would drastically raise out-of-pocket drug costs for millions of seniors. The Trump administration supports the health care repeal lawsuit and endorses full repeal of the ACA. Most recently, the administration rushed the confirmation of an anti-ACA Supreme Court justice just weeks before the U.S. Supreme Court is set to hear the repeal lawsuit.

The ACA closed the Medicare Part D coverage gap, or “donut hole.” Before the donut hole was closed, beneficiaries who reached a certain level of prescription drug spending had to pay the full cost of their prescription drugs until they reached an even higher spending threshold at which Medicare’s catastrophic coverage kicked in. Even with ACA protections, 1 in 4 seniors struggle to afford their medications. ACA repeal pushes prescription drug pricing changes in the wrong direction, making drugs even less affordable.

In short, without the ACA, costs for older people would rise, while coverage quality would dwindle. The ACA guarantees no cost sharing for preventive services and a yearly wellness check for Medicare beneficiaries. Without the ACA, seniors may have to delay or forgo essential screenings, potentially with long-term health consequences. ACA repeal would eliminate Medicare savings, causing some beneficiaries’ premiums to rise.

Lastly, ACA repeal could cause costs to skyrocket for Americans who have not yet qualified for Medicare. The ACA set limits on how much more insurance companies could charge people between ages 50 and 64; insurers may only charge them up to three times the amount they charge younger people for the same plan. This protection saves older adults thousands of dollars a year. Prior to the ACA, the age rating ratio in most states was 5-to-1 or higher, meaning that insurers regularly set premiums for this group of consumers at five times or more than premiums for younger people. If the ACA were repealed, people in this age bracket would once again face this “age tax.”

The Trump administration has failed to bring down prescription drug prices

The Trump administration has broken its promise to enact Medicare negotiation to bring down prescription drug prices for seniors. Instead of creating meaningful drug pricing reform to bring down astronomical drug prices, President Trump recently announced that he wants to send $200 discount cards to more than 30 million Medicare beneficiaries. Stakeholders and legal experts across political and industry spectrums have critiqued this gimmick as a last-minute, legally questionable approach that would not bring lasting help. The discount drug card program would cost a whopping $8 billion from one of Medicare’s trust funds, at a time when the program is already struggling to keep up with rising health care costs.

Not only has the Trump administration failed to propose meaningful drug pricing reforms, but it has also vowed to block legislation that would enact popular Medicare negotiation. H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act, passed the House of Representatives in late 2019 and, if enacted, would use Medicare negotiation to bring down prices for key drugs with great savings potential. The bill would cap out-of-pocket costs for drugs under the Medicare prescription drug benefit at $2,000, as well as expand Medicare coverage to include vision, dental, and hearing, which are all vital to promoting seniors’ health. Despite these historic and significant provisions that would vastly improve health care coverage and affordability for seniors, President Trump has promised to veto H.R. 3 if it is presented to him.

Conclusion

Time and time again, the Trump administration has let down seniors on health care. By failing to act on the coronavirus and pursuing a strategy that treats seniors’ lives as collateral damage, as well as refusing to enact meaningful drug pricing relief, the Trump administration has placed seniors’ well-being at the bottom of its priority list. The coronavirus has prevented seniors from seeing their grandchildren and visiting loved ones in the hospitals; it and the subsequent isolation caused by social distancing have a litany of known and unknown health implications. The administration failure to properly respond to the pandemic has had real, life-altering consequences for millions of seniors.

Nicole Rapfogel is a research assistant for Health Policy at the Center for American Progress.