What Trump Has Done With Medicare So Far
Remember those classic road trips where you’d be humming along, then suddenly hit an unexpected detour, or worse, realize your navigator (that’s you, trying to read a paper map at 65 MPH) sent you down a dead end? Navigating Medicare can feel a lot like that, especially when the landscape of policies and proposals keeps shifting. President Trump’s administration, now over 150 days into his second term, has introduced or initiated several changes to Medicare, adding a few new turns and potential speed bumps to that journey. Staying informed is like having a reliable GPS, it keeps you from getting lost.
The “Big Beautiful Bill” and Proposed Roads Ahead
One major proposed development comes from what the administration refers to as “Trump’s Big Beautiful Bill.” Think of this as a new set of road construction plans, aiming to reshape how some aspects of Medicare operate. If enacted, this bill includes several notable provisions. For example, it would allow working seniors who are eligible for Medicare Part A, but enrolled in a high-deductible health plan (HDHP), to continue contributing to their Health Savings Accounts (HSAs). This is a big deal, as HSAs can be powerful tools to save for future medical expenses, including Medicare premiums and co-pays. The bill also looks to bolster the fight against improper Medicare payments, allocating $25 million for artificial intelligence (AI) data scientists to investigate and recover funds, much like fixing potholes to keep the road smooth. Lastly, it proposes limiting Medicare eligibility for certain non-citizens, focusing benefits on those living in the U.S. through specific agreements or as lawful permanent residents.
Detours in Coverage
Sometimes a familiar route is simply closed off. That’s what happened when the Trump administration opted not to move forward with a proposal for Medicare and Medicaid to cover obesity treatments. Despite a prior proposal under the Biden administration to reinterpret the law and allow for coverage of weight-loss drugs for obese patients, this path was ultimately not taken. This decision means that, for now, Medicare, the federal health program for adults 65 and older, continues its longstanding prohibition against covering medication solely for weight loss, a rule that has been in place since 2003.
Streamlining the Journey
The administration is also focused on making the overall Medicare journey more efficient, much like a good highway department aims to reduce congestion and cost. This involves a few key initiatives aimed at streamlining operations and reducing federal spending. Early in the year, the U.S. Department of Health and Human Services (HHS) announced a significant restructuring, including a reduction of 10,000 full-time employees, projected to save taxpayers $1.8 billion annually. This move, framed as “realigning the organization with its core mission,” intends to do more with less. Furthermore, the Center for Medicare and Medicaid Innovation (CMMI) has plans to cancel six payment trials by the end of 2025, adjusting how healthcare providers are compensated. Additionally, oversight of the hospice industry, which receives billions annually from Medicare, has been put on hold to better target fraud and waste, ensuring our tax dollars aren’t just driving around in circles.
What’s on the Horizon for 2026 (and Beyond)
Even as current policies are debated and implemented, the road ahead already has some markers for 2026. These upcoming changes, while not all directly initiated by the current administration, are part of the evolving Medicare landscape you need to be aware of:
- Prescription payment plan updates: If you use the Medicare Prescription Payment Plan (MPPP), expect automatic re-enrollment each year unless you opt out.
- Cap on Part D prescription drug expenses: The out-of-pocket cap for Part D will increase to $2,100, up from $2,000 in 2025.
- Insulin costs capped: The $35 per month cap on insulin costs, introduced in 2023, will become an annual feature.
- Zero cost-sharing for adult vaccines: Free vaccines, previously limited, are now a permanent part of Medicare Part D plans.
Just like a good Boston driver knows the quickest way around traffic, knowing these changes helps you navigate your healthcare future with confidence.
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