Fact Sheet: Medicaid and Medicare During the Trump Administration
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Fact Sheet: Medicaid and Medicare During the Trump Administration
Medicaid
Overview:
- Medicaid is a joint federal and state program providing health coverage to low-income individuals, including families, children, pregnant women, elderly adults, and people with disabilities.
Key Actions:
Encouragement of Work Requirements: In March 2017, CMS Administrator Seema Verma sent a letter to state governors promoting the implementation of work or community engagement requirements for Medicaid beneficiaries.
Block Grant Proposal: The administration proposed converting Medicaid funding to a block grant system, aiming to give states more control over program design and spending. Critics expressed concerns that this could lead to reduced coverage.
Attempts to Repeal the Affordable Care Act (ACA): Efforts to repeal the ACA included plans to phase out the Medicaid expansion, potentially affecting millions who gained coverage under the expansion.
Medicare
Overview:
- Medicare is a federal program providing health coverage to individuals aged 65 and older, and to some younger people with disabilities.
Key Actions:
Medicare Advantage and Part D Enhancements: In April 2019, the administration announced changes to increase access to telehealth services and expand supplemental benefits for enrollees with chronic diseases.
Proposed Budget Cuts: The administration's proposed 2021 budget included reductions to Medicare spending, aiming to decrease program costs.
Prescription Drug Pricing: Efforts were made to address high drug prices, including proposals to allow Medicare to negotiate prices directly with pharmaceutical companies.
Recent Developments
- Federal Funding Freeze: In January 2025, a federal funding freeze led to temporary outages of Medicaid payment portals across all 50 states. The administration stated that Medicaid and the Children's Health Insurance Program were exempt from the freeze, and that provider payments continued despite the portal issues.
Conclusion
The Trump administration implemented significant changes to Medicaid and Medicare, focusing on increasing state flexibility, proposing budgetary adjustments, and addressing prescription drug costs. These actions have had lasting impacts on the structure and funding of these programs.
Sources:
Centers for Medicare & Medicaid Services. "Trump Administration Announces Changes to Medicare Advantage and Part D to Provide Better Coverage and Increase Access for Medicare Beneficiaries." April 5, 2019.
Reuters. "States say Medicaid access cut, White House says no payments disrupted." January 28, 2025.
The New York Times. "Trump to Scrap Critical Health Care Subsidies, Hitting Obamacare Again." October 12, 2017.
USA Today. "Social Security: Here's what Trump's proposed budget could mean for your benefits." February 12, 2020.
Recent administrative actions have introduced changes that could significantly impact Medicaid beneficiaries. Here's an overview of the potential effects:
Federal Funding Freeze and Its Implications
In January 2025, the administration announced a temporary freeze on federal grants and loans to review their alignment with recent executive orders. Although Medicaid and the Children's Health Insurance Program (CHIP) were stated to be exempt, technical disruptions occurred, leading to temporary outages of Medicaid payment portals across all 50 states. The administration assured that provider payments continued despite these issues.
Potential Budgetary Adjustments
To fund new policy initiatives, the administration is considering significant budgetary adjustments. Given commitments to preserve Social Security and Medicare, Medicaid may face substantial spending reductions. Such cuts could affect the scope of services and the number of individuals eligible for coverage.
Rescission of Previous Executive Orders
The administration has rescinded several executive orders from the previous administration that were related to the implementation of the Medicaid Act and the Affordable Care Act (ACA). This action may lead to changes in Medicaid expansion policies and other provisions that had increased access to healthcare for low-income individuals.
Conclusion
While some changes are still under review or subject to legal challenges, Medicaid beneficiaries should stay informed about these developments, as they may influence coverage and access to services.
Sources:
The Guardian. "Medicaid payment portals down after Trump's federal funding freeze." January 28, 2025.
New York Magazine. "Trump Needs Huge Safety-Net Cuts to Pay for His Agenda." January 25, 2025.
National Health Law Program. "President Trump's Day One Actions Threaten Medicaid and the ACA." January 27, 2025.
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