What Trump Has Done With Medicare So Far

Since President Trump was sworn into office on January 20, he has proposed or initiated changes impacting Medicare. Here's a roundup.

3D illustration of a rubber stamp with the text medicare and pills over paper background.
(Image credit: Getty Images)

Like Social Security, Medicare is a hot topic. Now that there’s a new administration in the White House, people, especially those over 65, are concerned about changes to healthcare programs like Medicare, and their access to affordable healthcare.

Since he was sworn in on January 20, Trump has signed a whirlwind of executive orders and proposed an ambitious agenda, including several key changes to Medicare — some of which have been walked back. Then, during Trump’s joint address to Congress, he outlined his plans for the next four years, including what he said was investigating overspending, fraud and waste within the Medicare and Social Security programs.

Medicare is the primary health insurance for adults aged 65 and older. It also covers those with certain disabilities or illnesses, such as end-stage renal disease or Lou Gehrig’s disease. As of ​​November 2024, just over 68 million people were enrolled in Medicare, including both Original Medicare and Medicare Advantage plans, according to the Centers for Medicare and Medicaid Services, at a cost of $839 billion in 2023. Trump's agenda could directly impact Medicare, a significant source of income for most people over age 65.

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Although it's still the early days of his second term, Trump has made several notable changes to Medicare. (A separate story looks at what Trump has done with Social Security so far).

Trump taps Robert F. Kennedy, Jr. to head the HHS

President-elect Trump has tapped Robert F. Kennedy Jr. to head the Department of Health and Human Services (HHS). The HHS has a nearly $2 trillion budget and oversees 13 separate agencies, including Medicare, Medicaid and the Affordable Care Act.

“I am thrilled to announce Robert F. Kennedy Jr. as The United States Secretary of Health and Human Services (HHS),” Trump posted on social media. “For too long, Americans have been crushed by the industrial food complex and drug companies who have engaged in deception, misinformation, and disinformation when it comes to Public Health.”

Read: RFK Jr. Now Heads HHS: How Medicare and Your Retirement May Change

Trump taps Dr. Mehmet Oz to lead the CMS

President Donald Trump tapped physician and TV personality Dr. Mehmet Oz to lead the Centers for Medicare & Medicaid Services (CMS). Dr. Oz's confirmation hearing was held on March 14. As of yet, no date has been set for the Senate Finance Committee to vote on whether or not to send his nomination to the full Senate. However, Oz has already proposed a vision for Medicare that would increase private-sector involvement in the form of Medicare Advantage plans.

Read: Trump Picks Dr. Oz as Head of Medicare and Medicaid

Medicare and Medicaid employees offered buyouts

Many of the 80,000 federal workers in the Health and Human Services Department (HHS) were emailed an offer to leave their jobs for (up to) a $25,000 payment, as part of President Trump’s government cuts. The mass email was sent to staff at the Centers for Disease Control and Prevention in Atlanta and the National Institutes of Health and the Food and Drug Administration, both in Maryland.

Federal employees had until 5 pm on Friday, March 14, to submit a response to the voluntary separation offer. Most federal employees received a deferred resignation offer this past January that came with eight months of pay. Thousands of probationary employees, too, have been fired across federal agencies, including at HHS.

Read: Trump Buyouts Spread to More Government Agencies: If You're Near Retirement, Should You Take a Buyout?

The Administration cancels some payment trials

Aligning with Trump's efforts to reduce costs while maintaining the quality of care, the Center for Medicare and Medicaid Innovation (CMMI) has announced plans to cancel six payment trials by the end of 2025. The changes by the Trump Medicare innovation center are meant to change the way healthcare providers are paid, according to Axios. These programs include initiatives like Primary Care First, Making Care Primary and End-Stage Renal Disease Treatment Choices.

Read: President Trump's Stances on Social Security and Medicare

Trump pauses hospice industry oversight

The administration has put a hold on a federal program designed to increase oversight of hospice care, which receives over $25 billion annually from Medicare. This pause is meant to root out and eliminate fraud and waste and address fraudulent billing and improper patient enrollments. The program, initiated during the Biden administration, required noncompliant hospices to take corrective action or face expulsion from Medicare.

Read: Hospice Is Often Misunderstood: What Is It, and Who Is It For?

OMB steps back funding freeze of Medicare grants and loans

On January 27, the Office of Management and Budget (OMB) issued a memo to temporarily pause the disbursement of federal grants and loans, including those for Medicare. However, before carrying through with the action, the OMB faced legal challenges and was blocked by federal judges. This led to confusion and concerns about potential impacts on Medicare funding.

Read: What a Federal Grants Pause Could Have Meant for Social Security and Medicare

Trump reverses Biden’s prescription drug price caps

The Trump administration has reversed price caps on prescription drugs. This includes medications like insulin, established under the Biden administration. Trump's reversal of Biden's order is unlikely to immediately increase the cost of prescription drugs for Medicare and Medicaid recipients. However, whether the move will make it easier for drug companies to raise prices in the future is unclear.

Read: Trump Revokes Biden's Order to Lower Drug Prices for Medicare

The Administration gives DOGE the green light

In the early days of his administration, President Trump signed an executive order creating the Department of Government Efficiency (DOGE) and made Elon Musk a “special government employee.” His role appears now to focus on federal technology and personnel in its goal to cut government spending, waste and fraud, and optimize the workforce.

Earlier this month, Musk said he believes Medicare payment systems are where “the big money fraud is happening.” Republicans in the House are poised to slash Medicare funds, despite concern from more moderate members. Under DOGE’s federal restructuring, many probationary employees were fired at the Centers for Medicare and Medicaid Services (CMS), the parent company for Medicare and Medicaid.

Read: What You Need to Know About Elon Musk's DOGE's Access to Medicare Systems

House Republicans' new funding bill

The new continuing resolution, CR, funding bill by House Republicans would maintain current federal spending levels through September 30, and have ongoing implications for those who receive Medicaid and Medicare. The bill will guarantee no disruptions in benefits. It would also postpone scheduled reductions to the Medicaid Disproportionate Share Hospital program, allowing low-income hospital providers to continue receiving support and extend services including telehealth, which was poised to end on March 31. The bill would also maintain full funding for veterans and their health care services and benefits.

Read: On Medicare and Need Telehealth? You Have Three More Months to Use These Services

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Kathryn Pomroy
Contributor

For the past 18+ years, Kathryn has highlighted the humanity in personal finance by shaping stories that identify the opportunities and obstacles in managing a person's finances. All the same, she’ll jump on other equally important topics if needed. Kathryn graduated with a degree in Journalism and lives in Duluth, Minnesota. She joined Kiplinger in 2023 as a contributor.