Medicare

WASHINGTON — Barbara Weigand could not have prepared more for retirement. She stayed healthy and saved diligently for years.

This year, though, a shoulder surgery and a bladder cancer diagnosis have really tested her finances. She recently withdrew $4,000 from her retirement account to cover medical expenses associated with her cancer treatment.

“On my monthly income, I would not be able to afford my new medical expenses,” says Weigand, 83, who lives in North Canton, Ohio. She is currently on a Medicare Advantage plan and was searching for new coverage as Medicare’s open enrollment period began in October.

For older adults in the United States, the rising cost of healthcare is hitting where it hurts most — their pocketbooks. With Medicare costs, prescription drug prices and long-term care expenses weighing on household budgets, their concerns could carry significant political weight heading into Tuesday’s elections.

Weigand is part of a reliable voting bloc; 83% of voters over age 50 say they’re extremely motivated to vote in the midterms, according to an AARP poll conducted in early October. Their concerns over managing healthcare costs put the issue of affordability squarely in the spotlight.

Here are some of their biggest healthcare concerns — and how Weigand sees them.

Changes to Medicare plans

Open enrollment for Medicare plans began in mid-October, and enrollees are facing a slew of changes that will go into effect in 2027.

During the enrollment period, people are considering higher Part D out-of-pocket caps, the end of temporary federal Part D premium subsidies, and new drug price negotiations. Additionally, in some states, insurers put caps on the number of people who can enroll in Advantage plans, pulling out of markets or eliminating plans that people have come to rely on.

Juliette Cubanski, director of KFF’s program on Medicare policy, told the Associated Press that the open enrollment period offers enrollees “an opportunity to evaluate the coverage they have and see if there might be better options for them in terms of accessing the care that they need, at possibly a lower cost.”

Although Weigand is grateful to have the mental acuity to do the research and the spiritual community that she relies on, she worries about other older people who are struggling to plan for the year ahead. “There are so many changes, and a lot of people my age who don’t know where to start,” she says. “What do they do?”

The affordability of prescription drugs

The Trump administration says it has made a priority of lowering drug prices in its effort to show that it is addressing soaring costs. President Trump has struck multiple most-favored-nation drug deals with pharmaceutical companies and has launched the discount drug website TrumpRx, among other steps.

In September, his administration said all 50 states would join in on a program set to provide most-favored-nation pricing to some drugs within the Medicaid program, bringing the net price of selected drugs down to prices paid in certain other countries.

Still, the cost of prescription drugs prevents some people from filling prescriptions. A KFF survey from March found that about 4 in 10 U.S. adults say they have not taken their medication as prescribed in the last year due to costs.

Weigand is considering rationing her drugs to save money. “I’ve been thinking — if I could just do this every other day rather than every day to make the medicine last longer,” she says. “Isn’t that sad?“

The KFF report says about 1 in 5 people surveyed had cut pills in half or skipped doses of medicine in the prior year because of the cost.

The costs of long-term support

The costs of receiving long-term care — whether from spouses, home-care aides or friends — have risen steeply for retirees.

An AARP report released Wednesday that examines out-of-pocket caregiving expenses finds that family caregivers are spending nearly 60% more supporting a family member or friend than five years ago. They spend an average of $11,508 a year supporting a family member or friend, compared with $7,242 in 2021, according to the report.

Nancy LeaMond, AARP’s executive vice president and chief advocacy officer, said “we’re already hearing from our members about healthcare affordability — its prescription drug costs, caregiver costs, copays, premiums,” she said. “Not only are we trying to help family caregivers with their finances, but also to get them the kind of information they need to help their loved ones.”

These worries are top of mind for older people. About one-third of Americans over 50 provide regular care to an adult relative or friend with a health issue or disability, according to a national poll on healthy aging conducted in September 2025 by the University of Michigan.

The solvency of Social Security

The Social Security Administration announced last month that the annual cost-of-living adjustment for older adults and people with disabilities will rise by 3.6% beginning in 2027. That translates to $75 extra per month for the nearly 72 million people who receive monthly Social Security benefits and about 7.3 million beneficiaries who get Supplemental Security Income.

The agency faces an approaching bankruptcy date if a funding shortfall is not addressed by Congress.

The Social Security and Medicare trustees’ report from June states that Social Security’s combined trust funds, which cover old age and disability recipients, will be unable to pay full benefits beginning in 2034. After that, incoming revenue would cover about 83% of scheduled benefits.

With 2034 not far away, the upcoming Congress will be faced with determining how to shore up the program.

Matt Hogan, a partner at the polling firm Impact Research, has this advice to candidates in the closing days of the midterm campaign: “Regardless of party, to make inroads with these voters, Social Security and Medicare should definitely be part of their messaging.”

Hussein writes for the Associated Press.

WASHINGTON — The Trump administration is deferring an additional $1.2 billion in Medicaid reimbursements to California, citing concerns about potential fraud in a state program that helps older adults and people with disabilities with everyday tasks.

Dr. Mehmet Oz, the administrator for the Centers for Medicare and Medicaid Services, said federal officials took action after they grew concerned about the rapid expansion of California’s personal care services program in recent years. State officials were notified of the decision Tuesday, he said.

“California has been growing that program 24% in the last three years. That is twice the rate of every other state average in the country,” Oz said. “Impossible for us to understand how that could be so we are taking major action in California.”

Oz did not provide any evidence of fraud but suggested the state was paying people too much taxpayer money to help with services that could be offered for free, like “paying somebody to carry groceries upstairs for your mom.”

“Many of you would carry groceries upstairs for your mom for free, but in California, they will pay you a lot of money for it,” he said.

The move is the latest in a series of efforts by the administration to withhold federal money from California. In May, the administration held back $1.3 billion in Medicaid reimbursements to the state over concerns about “fraudsters” in the state’s hospice and in-home care programs. The actions have been part of a broad effort by the administration to rein in fraud in federal healthcare benefits programs, particularly in Democrat-led states.

Gov. Gavin Newsom’s office did not immediately respond to a request for comment. But the office has been critical of the administration’s past efforts.

In May, Newsom’s office called the action to withhold funds for in-home care programs a “sick” and politically motivated attack on services that are meant to “keep seniors and people with disabilities OUT of nursing homes.”

Those services usually cover assistants who help people with daily tasks such as bathing, laundry or cooking. They also provide needed care such as injections under the direction of a medical professional. A 2020 report by the California state auditor found that nearly three-quarters of In-home Supportive Services caregivers assist a family member.

Newsom’s office, however, has argued that the program saves taxpayers money, saying IHSS care costs $30,000 a year, while nursing home care costs $137,000 a year.

California’s hospice industry has had problems in the past and authorities have tried to crack down on the issue. A Times investigation in 2020 found that providers were billing Medicare for hospice services and equipment for patients who were not actually dying while the industry boomed.

The Trump administration, led by Vice President JD Vance, has tried to focus attention on the issue of waste, fraud and abuse as a centerpiece policy platform to bring down healthcare costs.

On Tuesday, Trump and Vance announced a $25-million whistleblower program designed to pay out cash to people who tip off the federal government about fraudsters. The program will offer a 1% commission for tips that lead to a successful conviction. Trump said he would be the sole arbitrator of who gets to keep the money.

“I’ll determine whether or not the person is deserving, and I will be very generous believe me. We are not looking to save on that,” Trump said. “I promise you I will be fair.”

Trump said the money will be handed out “expeditiously and fairly.”

“I promise there is nothing in this for me,” he said.

The White House referred comment about the decision to the Centers for Medicare & Medicaid Services. The federal agency did not immediately respond to a request for comment.

WASHINGTON — Investments in pharmaceutical companies made on behalf of President Trump increased significantly after he returned to the White House last year, with his portfolio adding millions of dollars in stock in firms that benefited from a Republican-backed law that shields certain medications from Medicare price negotiations, according to a report from congressional Democrats.

The report, released Friday by the Joint Economic Committee’s minority arm, found that Trump’s pharmaceutical stock holdings grew from a maximum reported value of $1.7 million in 2024 to as much as $56.2 million at the end of 2025. The report said that included up to $39.1 million worth of stock held in companies that benefited from exemptions to Medicare’s drug price negotiation program, which came through a provision in the Republicans’ 2025 tax and spending law.

Additional analysis of Trump’s financial disclosures provided by committee Democrats showed that his investment portfolio bought as much as $2.55 million in shares of pharmaceutical companies benefiting from the exemptions on three dates before he signed the legislation in July 2025. That included up to $950,000 in purchases on July 1, 2025, the day the Senate passed the bill. His portfolio also bought as much as $1 million in AbbVie stock in August 2025, after the bill became law.

The Republican president’s wealth has grown since he took office last year through a web of business interests, many of which have benefited from the policy moves of his administration. The White House has repeatedly denied any ethics issues and accused Democrats of “attempts to fabricate conflicts of interest.”

The report also noted that the exemptions policy could leave some Medicare beneficiaries paying thousands of dollars more for certain cancer treatments and other medications than they would have if Medicare had been allowed to negotiate lower prices.

The findings come as Trump has made lowering prescription drug costs a central part of his healthcare policy, striking deals with pharmaceutical companies that his administration says will make medications more affordable for Americans, although drug pricing is based on a complicated set of factors.

Recent polling from the Associated Press-NORC Center for Public Affairs Research shows that most Americans think Trump is profiting off the presidency in unethical or illegal ways and is focused more on his wealth than on helping people like them.

Democratic Sen. Maggie Hassan, who leads the Joint Economic Committee’s minority arm, called the report’s findings “outrageous and yet typical from this president, who makes the American people foot the bill again and again for his own gains.”

Davis Ingle, a White House spokesperson, said Trump’s stock and bond portfolio is independently managed by third-party financial institutions. He denied any conflict of interest.

“Neither President Trump nor any member of his family has any ability to direct, influence, or provide input regarding how the portfolio is invested or when investments are bought or sold,” Ingle said in a statement.

A law from President Biden’s Democratic administration allowed Medicare for the first time to negotiate prices for some of the costliest prescription drugs. Republicans’ 2025 tax and spending bill expanded an existing exemption for medications developed to treat rare diseases or conditions, delaying when certain costly drugs could become eligible for negotiations or excluding them entirely, according to healthcare research nonprofit KFF.

Also known as the orphan drug exclusion, the carve out allows drug companies to continue charging lucrative prices that might otherwise have been reduced through Medicare negotiations.

Supporters of the change argued that a broader exemption would encourage drug companies to develop treatments for rare diseases. Critics say it allows makers of blockbuster medications to avoid negotiations that could lower costs for Medicare and its recipients.

The report estimated that Medicare beneficiaries receiving the cancer drugs Keytruda, manufactured by Merck, and Opdivo, by Bristol Myers Squibb, could pay roughly $5,000 more annually than they would if Medicare negotiated prices for the medications. Trump’s portfolio includes stock in both firms.

The report also said that Trump’s portfolio continued to buy and sell pharma company stocks throughout the first eight months of 2026, adding as much as $3.5 million in stock wealth in the sector.

All recent U.S. presidents have dumped their stocks before assuming office, put their money in broadly diversified funds or set up a “blind” trust so they couldn’t even know what they owned.

Trump has put his broader business interests in a trust managed by his sons. But the arrangement rejects the conflict of interest protections that his recent predecessors in office had instituted.

Hussein writes for the Associated Press. AP writer Bernard Condon in New York contributed to this report.

WASHINGTON — President Trump says his administration will make one-time payments of $90 per person to help more than 20 million Medicare enrollees pay for their Part B premiums. It will cost about $2 billion.

Less than one-third of all Medicare recipients are eligible for the payments, which are expected to be sent out this week. Not eligible are roughly 35 million Medicare Advantage enrollees, millions of people with disabilities who get premium assistance and low-income Medicare recipients.

The election-year promise that the Republican president made over the weekend comes as the Nov. 3 midterms are fast approaching, with the cost of living and healthcare expenses among the top issues for voters.

Some questions and answers about the payouts:

Who will benefit?

Some 20.8 million people in the original Medicare Part B who are living in the United States, not receiving premium assistance from Medicaid or not paying an income-related monthly adjusted amount.

Medicare Advantage enrollees, who make up more than half of the eligible 64.2 million Medicare beneficiaries, will not receive a payment, according to KFF, a healthcare research nonprofit. Nor will 12 million low-income older adults and people with disabilities who get premium assistance.

The Part B program covers expenses such as doctor’s visits, ambulance services and lab tests. Total monthly costs generally start at about $200 and vary with income.

Allison Schuster, a White House spokeswoman, said in a statement that the administration “is enabling Americans to take control of their health by putting money directly back in the hands of Medicare patients.”

When will the payments go out and how will they be disbursed?

According to the Centers for Medicare & Medicaid Services website, eligible beneficiaries will receive one $90 rebate this month, with most getting a direct deposit on or around Friday. Others will receive a paper check from the Treasury Department later in October.

Juliette Cubanski, director of KFF’s program on Medicare policy, said the payment will be automatic.

“As far as a benefit goes, people don’t have to call or sign up — it’s just money they receive directly, but not everybody on Medicare will receive this money.”

A White House fact sheet says people can call (800) MEDICARE ([800] 633-4227) to check their eligibility for the premium rebate. To check on payment status, people should call the Social Security Administration at (800) 772-1213.

What is the source of the money?

Payments will come out of the Medicare Improvement Fund created by Congress in 2008 and intended to make improvements to the Medicare fee-for-service program.

The fund was created to improve program management and conduct oversight of contracts and contractors, according to the Congressional Budget Office, but its purpose has expanded after various legislative changes.

This is not the first time the fund has been used.

President Obama’s administration, along with Congress, redirected $20 billion to expand healthcare coverage through the Affordable Care Act.

But under Trump, it is the first time that the fund has been used to directly pay recipients.

What are critics of the plan saying?

Critics of Trump’s promise characterize the $90 payments as a preelection stunt designed to sway voters rather than address structural problems in healthcare costs and administration.

The top Democrat on the Senate Finance Committee, Oregon Sen. Ron Wyden, said in a statement that “this is another desperate attempt by a failed president to escape Americans’ revulsion with his failed agenda, amounting to one tank of Trump-inflated gas.”

Trump recently promised $500 rebate checks to an estimated 1 million Obamacare enrollees across 30 states whom the White House alleged were overcharged by the Biden administration for some fees.

Cubanski said the Medicare rebate payments were being doled out when Americans were feeling the bite of higher food, energy and gas prices. Surging healthcare costs are only compounding those pressure, she said.

“This might be helpful for people but it might not go very far.”

Hussein writes for the Associated Press.