USA Today gave President Trump a big gift Wednesday by publishing a largely fact-free attack on the “Medicare for all” plan promoted by Sen. Bernie Sanders (I-Vt.), disguised as an op-ed written by Trump himself.

In strictly factual terms, the op-ed bristles with lies and misrepresentations about Medicare for all, Medicare itself, Trump’s own healthcare policies, and Democratic and Republican approaches to Medicare.

But before we get to those points, let’s cover a broader issue: The ethics of USA Today’s publication of this piece.

To begin with, although it bears Trump’s name, does anyone actually believe he wrote it? The article’s diction and syntax are far more cogent than anything known to have originated from him personally. Leaving aside its manifest inaccuracies, it shows at least a working grasp of some aspects of the Medicare program not known to be in his wheelhouse.


The Democrats’ plan ... would eviscerate Medicare. President Trump on Sen. Bernie Sanders’ proposed Medicare for All Act

Of course, ghost-written articles and op-eds by politicians, business leaders and entertainment figures are a common feature of our public discourse. Campaign “autobiographies” are seldom self-written, nor are position papers routinely issued over the names of congressional leaders.

But this is an entirely different case. It’s an open attack on Trump’s political adversaries, presented in a format that allows USA Today to avoid any fact-checking whatsoever. It’s not as though Trump is bereft of any other means to get his position across. USA Today had no business turning over a sizable chunk of its online and print real estate to Trump for the equivalent of a campaign rally.

Now, to the details. The target of the op-ed is the Medicare for All Act, a Sanders proposal to replace almost all private health insurance and public programs with government-funded health coverage modeled on Medicare. Sanders’ plan would eliminate private and public premiums, deductibles and other co-pays. It would provide universal coverage, including dental, vision and hearing care for everyone. The op-ed calls this “socialism.”


Let’s take the article’s points one by one.

—The proposal would “end Medicare as we know it and take away benefits that seniors have paid for their entire lives.”

The first claim is true. The proposal would replace Medicare as we know it — with a vastly expanded program. But nothing in it would “take away benefits” from seniors — in fact, it would expand their benefits and eliminate their out-of-pocket expenses.

—The proposal would “cost an astonishing $32.6 trillion during its first 10 years.” The op-ed links here to an analysis produced by conservative commentator Charles Blahous for the right-wing Mercatus Center at George Mason University. As we’ve explained before, the figure it quotes is flagrantly misleading.


The Blahous analysis actually found that Medicare for all would reduce nationwide spending on healthcare by $2 trillion over 10 years. That $32.6 trillion cited in the op-ed is Blahous’s estimate of the increase in federal government spending on healthcare under the proposal — but it doesn’t account for the savings in private spending, or for the expanded services that would be provided to a larger national clientele.

—“As a candidate, I promised that we would protect coverage for patients with preexisting conditions and create new healthcare insurance options that would lower premiums …. We are now seeing health insurance premiums coming down.” Trump may indeed have promised these things on the campaign trail. In actual policymaking, he has failed to deliver the first and is misrepresenting the second.

The Trump administration has in fact asserted that key provisions of the Affordable Care Act are unconstitutional, including its protections for people with preexisting conditions. This occurred in June, when the administration refused to defend the law against a legal challenge brought by 20 red states. A coalition of Democratic-controlled states has stepped in to take up the defense, but if they fail, Trump’s action will have eliminated protections for people with medical conditions.

As for those new healthcare options, it’s true that some of the options Trump has provided for, such as short-term bare-bones health plans, would carry lower premiums for customers who qualify. But those plans generally don’t cover preexisting conditions. Their premiums are lower because their coverage is skimpier. Moreover, the effect of expanding access to those plans could be to raise premiums for patients in ACA-compliant plans.


As it happens, the Senate’s GOP majority on Wednesday blocked a resolution offered by Sen. Tammy Baldwin, D-Wisc., to stop insurers from selling those short-term plans—another sign of the Republicans’ carelessness about protecting people with preexisting conditions.

Are Obamacare premiums coming down, as Trump claims? In some places, yes. But in every state where insurers have filed 2019 premium requests, the premiums would have been even lower if not for the Trump administration’s concerted effort to sabotage the Affordable Care Act.

—The Democrats’ plan … would eviscerate Medicare.” The truth is that the only politicians who are talking about cutting Medicare benefits are Republicans. The talk has come from Sen. Marco Rubio (R-Fla.) and House Speaker Paul D. Ryan (R-Wis.), among others. Generally, their argument is that Medicare is one of the chief drivers of the federal deficit (though the Republican-passed tax cuts last December are expected to cost more than $1.5-trillion over 10 years).

The New York Times analysis linked to in that passage, by the way, doesn’t remotely say that the Sanders proposal would “eviscerate Medicare.” It says that it would give Medicare enrollees “more generous coverage,” generally with lower out-of-pocket expenses.


—“Democrats have already harmed seniors by slashing Medicare by more than $800 billion over 10 years to pay for Obamacare.” This is an ancient canard. The Affordable Care Act aimed to reduce Medicare spending by about that much by reconfiguring reimbursements to doctors and hospitals to save money and impose more scrutiny on insurance companies offering Medicare Advantage plans, some of which have been overpaid in relation to their actual value. The act didn’t cut Medicare benefits or “slash” the program. In any case, Republican budget proposals kept the Medicare changes in place, to capture the exact same savings.

The rest of the Trump op-ed is garden-variety Trumpian partisan posturing: “The new Democrats are radical socialists who want to model America’s economy after Venezuela,” etc., etc. This prompts us to ask again: What is USA Today’s excuse for accepting this piece for publication?

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UPDATES:

9:52 a.m.: This post has been updated with news of the Senate majority’s rejection of a resolution to ban the short-term health plans favored by Trump.