In 2025, the Trump administration let key Medicare protections lapse and made choices that favored insurers over patients. When funding ran out on October 1, Medicare’s extra telehealth and Hospital-at-Home options ended, so many seniors lost coverage for home video visits and some had to leave at-home hospital care. Earlier in April, the administration also stopped a plan that would have let Medicare cover popular anti-obesity drugs, keeping most seniors from getting that benefit. At the same time, a big tax-and-spending law increased the deficit, which could trigger automatic Medicare cuts starting in 2026 unless Congress steps in. The administration approved higher payments to Medicare Advantage plans even though experts say those plans are already overpaid, which can strain Medicare’s finances and raise costs for seniors. It also eased oversight by dropping a major enforcement fight and allowing limits on misleading marketing rules to fall, weakening protections for beneficiaries.
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¶ Trump's Government Left Medicare telehealth access and Hospital-at-Home To Expire in October 2025
- Congress extended most Medicare telehealth flexibilities only through September 30, 2025; absent further action, pre‑pandemic geographic and originating‑site restrictions return, limiting home‑based telehealth for non‑behavioral care. (telehealth.hhs.gov)
- When government funding lapsed on October 1, 2025, Medicare’s authority to reimburse expanded telehealth and the Acute Hospital Care at Home program expired, forcing hospitals to discharge or move patients and leaving many seniors’ telehealth visits unreimbursed. (axios.com)
- Clinical and specialty groups report that as of October 1, 2025, home‑based non‑behavioral telehealth and audio‑only services are no longer covered under traditional Medicare absent new legislation. (aad.org)
- On April 4, 2025, CMS announced it would not proceed with a late‑2024 proposal to allow Medicare and Medicaid coverage of GLP‑1 obesity medications, leaving most Medicare enrollees without coverage for these treatments. (cnn.com)
- Analyses of the shelved proposal indicated it would have expanded access to millions of beneficiaries, albeit at significant federal cost; blocking it preserved current exclusions and limited access for seniors. (healthaffairs.org)
- CBO told Congress that the “One Big Beautiful Bill Act” would add about $2.3 trillion to the deficit over 10 years, activating sequestration that would cut Medicare by up to 4% annually—nearly $490 billion over a decade—starting in 2026 unless Congress acts to avert it. (washingtonpost.com)
- Subsequent reporting reiterated CBO’s finding that the Trump tax/spending package could force roughly $491 billion in Medicare cuts between 2027 and 2034 absent a waiver, despite promises not to cut Medicare. (apnews.com)
- CMS finalized a 5.06% average increase in payments to Medicare Advantage plans for 2026—larger than initially proposed—adding over $25 billion for plans next year. (cms.gov)
- Independent analysis estimated the change would translate to roughly $35 billion more to MA plans in 2026 compared with 2025. (kff.org)
- MedPAC projected Medicare will overpay MA plans by about $84 billion in 2025 (roughly 20% more than traditional Medicare for similar beneficiaries) due to coding intensity and favorable selection. (beckerspayer.com)
- Budget watchdogs estimate MA overpayments could total about $1.2 trillion over 2025–2034, straining the Medicare Hospital Insurance trust fund and raising beneficiaries’ premiums. (crfb.org)
- Insurer stocks rallied on the larger‑than‑expected 2026 MA raise, with analysts attributing the favorable outcome to a more MA‑friendly posture under the Trump administration. (apnews.com)
¶ Oversight and beneficiary protections were weakened in ways that favored insurers
- CMS abruptly dropped an appeal in a case over UnitedHealth’s Medicare Advantage Star Ratings recalculation, easing a significant enforcement action and signaling a softer stance toward plan accountability. (reuters.com)
- A federal court vacated key marketing‑reform provisions intended to curb misleading Medicare Advantage sales tactics; policy analysts warned the new administration might decline to defend such rules, leaving beneficiaries more exposed. (medicareadvocacy.org)