Take a Deep Breath, Please – No One is Gutting Medicare

While we understand that many people are disappointed with the results of the election and President-Elect Trump’s nominations for key health offices, we have been taken aback with some of the dooms day calls we’ve received of late. Robert F. Kennedy, Jr., hasn’t been confirmed and we realize journalists have to write about something, but most of the speculation about what influence he will have is premature.

Are we entering a tumultuous period in healthcare? Yes we are. Medicare Advantage Plans are under assault on many fronts but too many plans were engaged in questionable practices to inflate payments. Medicare Advantage Plans are largely for-profit companies which answer to shareholders but they will adjust. That doesn’t mean Medicare or Medicare Advantage are going away. The Medicare program started in 1966 and has almost 70 million Americans enrolled. 

We also can’t know what might happen with key provisions of the Inflation Reduction Act, the $2000 out-of-pocket maximum for Medicare Part D in 2025 and the creation of the Drug Negotiation Program. The Inflation Reduction Act passed without a single Republican vote and healthcare is political. 

Again, please remember that Medicare has been with us for decades and has largely evolved to provide more coverage, not less.

We are also facing more turbulence in the individual market because enhanced subsidies are set to expire at the end of 2025. If those enhanced subsidies are not renewed, it is very possible that we will see the ranks of the uninsured increase in 2026 and beyond. But after ten years and so many challenges, it seems a reach to think the Affordable Care Act will be repealed. Many states that were initially opposed to the ACA have moved in the direction of embracing the program, deciding to expand Medicaid and even setting up their own exchanges. That said, there are still ten states that have not expanded Medicaid.

Anyway, we often deal with people who don’t understand their coverage as well as they need to. Our system can be very cruel and unforgiving so please familiarize yourself with your situation and understand what type of product you are on, basics like the deductible and out-of-pocket maximum, how your coverage is paid for, the network, the rules of the plan and open enrollment deadlines. You can learn a great deal from your personal insurance company portal so if you haven’t created access to your account or accounts, please do so. 

And sometimes avoiding newspaper articles is good for your state of mind. We hope everyone can enjoy this holiday season!