With a new administration in the White House and the Department of Government Efficiency (DOGE) actively working to cut government spending, Medicaid and Medicare have become discussion points. Starting as early as January 20th, President Trump has initiated a series of executive actions and proposed an agenda that would significantly change Medicare. Addressing Congress in March, Trump outlined his intentions for his second term, emphasizing investigations into overspending, fraud, and waste within the Medicare and Social Security systems.

Medicare is the primary federal health insurance provider for individuals aged 65 and older. It also covers those with specific disabilities or illnesses. As of November 2024, over 68 million people were enrolled in Medicare, including both of the main types of Medicare coverage — Original Medicare and Medicare Advantage plans. In 2023, the program cost taxpayers $839 billion. As Medicare is the primary healthcare provider for millions of individuals over 65, Trump’s policies would have a considerable effect and cause millions of people to lose access to healthcare.

Trump has already implemented several notable changes to Medicaid and Medicare. One significant decision was the appointment of Robert F. Kennedy Jr. to lead the Department of Health and Human Services (HHS). HHS oversees key healthcare programs including Medicare, Medicaid, and the Affordable Care Act. Shortly after his appointment, Kennedy initiated a reduction of approximately 10,000 full-time positions within HHS and announced a plan to streamline operations by consolidating numerous divisions, creating a new entity called the Administration for a Healthy America (AHA). This new agency would also reduce the Centers for Medicare and Medicaid Services (CMS) workforce.

President Trump has also nominated Dr. Mehmet Oz to head CMS. Dr. Oz has repeatedly avoided directly answering questions from Democrats regarding potential Republican-led cuts to Medicaid. Republican senators have focused on Dr. Oz’s strategies for combating fraud within the Medicare and Medicaid programs. Despite persistent questioning, Dr. Oz did not commit to opposing future cuts to Medicare or Medicaid. His nomination was confirmed by the Republican controlled Senate with a party-line vote of 53-45.

The Center for Medicare and Medicaid Innovation (CMMI) announced the cancellation of several payment trials by the end of 2025. Medicare and Medicaid payment trials refer to how government-funded healthcare programs cover the costs of routine care for individuals participating in clinical trials or research studies designed to evaluate new treatments and medical interventions. Additionally, the administration has temporarily halted a federal program designed to increase oversight of the hospice care industry, which receives substantial funding from Medicare annually. 

The Office of Management and Budget (OMB) also issued a memo to temporarily pause the distribution of federal grants and loans, including those for Medicaid and Medicare. However, legal challenges led to federal judges blocking this action, creating uncertainty about potential impacts on Medicare funding. As of late February 2025, this block remained in place, hindering the Trump administration’s efforts to reduce federal spending.

Furthermore, the Trump administration has reversed some of the previous administration’s prescription drug price cap negotiations. While this reversal is not expected to immediately increase drug costs for Medicare and Medicaid beneficiaries, its long-term implications for drug pricing remain unclear. Certain Medicare cost reduction measures established under the Inflation Reduction Act (IRA) can only be repealed by Congress.

Early in his administration, President Trump created the Department of Government Efficiency (DOGE) and appointed Elon Musk as a special government employee. DOGE has since taken responsibility for modernizing the Medicare enrollment system to reduce costs following unsuccessful prior efforts. Musk has publicly stated that significant fraud exists within Medicare payment systems. Under DOGE’s restructuring, numerous employees at CMS were terminated. While a U.S. District Judge declined to block DOGE’s operations within several government agencies, the court did order further investigation into DOGE’s handling of sensitive data.

Following Senate approval last week, the House of Representatives voted to move forward with a budget plan that anticipates significant cuts to healthcare and other essential programs. The measure passed 216-214, with Republican Representatives Massie (R-KY) and Spartz (R-IN) voting against it with Democrats. As both chambers now have identical budget frameworks, they will begin drafting the specific bill. The House vote was briefly delayed due to some Republicans objecting to the Senate’s lower $4 billion savings requirement for committees, preferring the House’s $1.5 trillion 10-year savings goal. This difference was resolved after Speaker Johnson and Majority Leader Thune pledged to pursue at least $1.5 trillion in savings in the reconciliation package, calling for substantial cuts to programs like Medicaid.

The core of the budget plan involves extending the 2017 Trump tax cuts and proposing up to $1.5 trillion in new tax breaks. Republicans are downplaying the plan’s financial impact using a novel accounting method to claim these extensions will be cost-neutral. This claim is widely disputed by experts who estimate the plan will add at least $4 trillion to the national deficit. The budget also increases military and border security spending while mandating significant cuts to committees overseeing healthcare, nutrition, housing, education, energy, and labor. Additionally, it includes a roughly $5 trillion increase to the debt limit, intended to last beyond the 2026 midterm elections.

When it comes to participating in the discourse and potential policy changes surrounding Medicare, there are several avenues to do so. Here are some common methods:

• Calling and Writing: Members of Congress will be home for a two-week recess, from Saturday, April 12, through Sunday, April 27. Now is the time to remind them that their votes have consequences, and that such a reconciliation bill as has been proposed would harm their constituents, district, and state. Use this map to find out how many people in your district rely on Medicaid and share that number with your representatives. Call 866-426-2631 to contact your members of Congress.

• Scheduling Meetings: Many representatives have staff dedicated to scheduling meetings with constituents. You can contact their local or Washington, D.C. office to request a meeting to discuss your concerns about Medicaid and Medicare. While meeting directly with the representative may not always be possible, you can often meet with a staff member who handles healthcare policy. Be prepared to clearly articulate your points and any specific concerns or proposals you have.

• Signing and Creating Petitions: Online platforms often host petitions related to healthcare and Medicare. Signing these petitions can add your voice to a collective effort. You can also create your own petitions to advocate for specific changes.

• Joining Advocacy Groups: Organizations like AARP actively advocate for the interests of older adults, including Medicare beneficiaries. Joining such groups can amplify your voice

• Supporting Advocacy Organizations: Contributing financially to organizations that advocate for Medicare can help fund their efforts to influence policy.

• Participating in Protests: When organized protests or demonstrations occur regarding Medicare, participating can raise public awareness and exert pressure on policymakers.

• Staying Informed: It’s crucial to stay informed about current Medicaid and Medicare policies and proposed changes. To learn more, visit sources like the Kaiser Family Foundation

• Voting: Voting in local and national elections is a very important way to have your voice heard.