By Charles Sauer, Market Institute
Republican voters are increasingly frustrated with insurance companies, a concern President Trump recognized when he pledged to take on big insurance and put patients back at the center of healthcare. However, the problems might be even easier to fix than that.
New polling from Market Institute and President Trump's pollster Fabrizio Ward shows just how strongly voters agree that government needs to do something when it comes to Alzheimer's care. Eighty-nine percent of voters are concerned that insurance delays and out-of-pocket costs prevent Alzheimer's patients from accessing FDA-approved treatments. Nearly four in five say they are more likely to support candidates who prioritize improving access to Alzheimer's care.
These voters are recognizing a real problem. Across the country, Alzheimer's patients who qualify for therapies approved by the U.S. Food and Drug Administration are facing repeated coverage delays and denials, even after their physicians determine they are appropriate candidates for treatment.
Families understandably blame their insurance companies. But there is another culprit at work: an outdated government policy that Republicans would be wise to tackle before the midterms.
The little-known Medicare policy is called Coverage with Evidence Development, or CED. When Medicare first began covering the new generation of Alzheimer's therapies, it took the unprecedented step of imposing additional conditions on coverage, requiring physicians to enroll patients in registries and submit ongoing data as a condition of reimbursement.
That decision reverberated throughout the healthcare system. When Medicare, the nation's largest healthcare payer, treats FDA approval as insufficient on its own, private insurers take notice. The result has been predictable: insurers have frequently labeled FDA-approved Alzheimer's treatments "investigational" or "experimental" and denied coverage, despite those therapies having already met the nation's highest standard for safety and effectiveness.
In other words, CED—a policy put in place under prior administrations—has inadvertently taught insurers to say "no."
The consequences are not theoretical. They affect real patients.
Consider Lori Baetz, a retired engineering technician from Michigan who was diagnosed with Alzheimer's disease. Despite qualifying for treatment, she encountered repeated insurance barriers that delayed her access to care at a time when every month matters. Her experience illustrates what thousands of families have discovered: scientific breakthroughs mean little if outdated government policies continue encouraging insurers to stand in the way.
President Trump has an opportunity to reverse course. Eliminating Coverage with Evidence Development would remove outdated federal red tape that has outlived its original purpose and help restore timely access to Alzheimer's care.
The politics are just as compelling as the policy. Eighty-seven percent of voters say fighting Alzheimer's should be a national priority. In Market Institute focus groups, one Republican voter put it simply: "If somebody actually said the word Alzheimer's in their platform to get elected, people would notice because it's different."
President Trump and congressional Republicans have an opportunity to modernize Medicare's outdated Alzheimer's coverage policies. Doing so would remove a major regulatory excuse for unnecessary denials, restore physicians — not insurance companies — to the center of treatment decisions, and ensure American patients can benefit from one of the most promising medical breakthroughs in decades.
As it stands, patients can do everything right. They can recognize symptoms early, seek out specialists, undergo sophisticated diagnostic testing, and qualify for treatment, only to discover that outdated federal policy has tilted the system toward delay instead of care. That isn't the patient-centered healthcare President Trump has championed, and it isn't the kind of innovation America should settle for.
Taking on big problems like Alzheimer’s means more than criticizing bad behavior. It means taking action and removing the government policies that enable it. Modernizing Medicare's Alzheimer's coverage framework would do exactly that, giving physicians greater freedom to practice medicine, patients faster access to lifesaving innovation, and families renewed confidence that healthcare decisions are once again being made in the exam room rather than the boardroom.
Charles Sauer is president of the Market Institute.
