The Senior Citizens League (TSCL) Monthly Washington Update for the end of March 2025
Since his second inauguration as President in January, President Trump has implemented numerous changes within the federal government, including sweeping personnel cuts across all departments and agencies. At the same time, those cuts have resulted in over one hundred lawsuits, seeking to stop his actions by questioning his legal authority to take the actions he has. While some of the lawsuits have resulted in a halt to what he ordered, other of his actions have taken effect.
In addition, his placing of broad-based tariffs on goods from numerous countries could have a profoundly negative impact on the daily lives of seniors, including the costs of drugs and medical equipment that many seniors rely on.
In this issue of the TSCL Update, we review what effect President Trump’s actions have had so far on the programs that are of importance to seniors: Social Security, Medicare, and Medicaid.
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Trump’s Tariffs and Seniors
While President Trump and his advisors believe that his tariffs will result in billions of dollars of new revenue for the government, many top economic analysts disagree. They believe the tariffs will amount to a new tax that U.S. consumers will have to pay for goods and services they depend on for their everyday needs.
Another term for “tariff” is “import tax,” and former Vice President Mike Pence has referred to the tariffs as the largest tax increase in U.S. history.
The U.S. Chamber of Commerce’s chief policy officer, a former House Republican aide, has said, “broad tariffs are a tax increase that will raise prices for American consumers and hurt the economy.”
The Journal of the American Medical Association has estimated that the import taxes could affect as many as 400 drug products from Canada alone. The U.S. also imports far more drug products from China, India, and Mexico, each of which has been targeted for higher import taxes.
It is also highly likely that import taxes will keep food prices high, increase auto insurance costs, and contribute to higher inflation, among other effects.
President Trump himself has said, “Will there be some pain? Yes, maybe (and maybe not), but we will make America great again, and it will all be worth the price that must be paid.
Some Republican members of Congress also acknowledge that Americans will be paying more.
Oklahoma Republican Senator Markwayne Mullin was asked if his constituents are ready to pay higher prices. Mullin said, "I think our constituents are going to do what it takes to get America back on track." We're tired of countries taking advantage of us."
Representative Mark Alford, a Republican from Missouri, told CNN that tariffs are "going to have an impact," particularly on farmers. However, he expects some offset to the costs through increased domestic energy production. "We all have a role to play in this to right size our government, and if I have to pay a little bit more for something, I'm all for it to get America right again, to start whittling down" the debts, he said.
Asked if he thinks his constituents feel the same way about shouldering some of the costs, Alford said: "I think so."
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The Trump Administration and Social Security
The first thing to note is that while TSCL applauds efforts to combat fraud, waste, and abuse, it is also essential that the needs of those who rely on Social Security, Medicare, and Medicaid are considered. We want careful consideration to be given before any changes are implemented.
Unfortunately, what appears to have happened so far is that Elon Musk and his “DOGE” team have swung the axe first to achieve significant cuts in personnel within the federal government without ever evaluating how these cuts would affect the services the American people, especially seniors, depend on.
While President Trump has stated several times that he will not cut Social Security or Medicare, and even included Medicaid on that list at times, Elon Musk has made no such statement.
Musk has said Social Security is "the biggest Ponzi scheme of all time." He recently highlighted the cost of federal spending on entitlement programs.
“Most of the federal spending is entitlements. So that’s the big one to eliminate. That’s the sort of half trillion, maybe six, seven hundred billion,” Musk said on Monday in an interview with Fox Business News. Musk’s comments came in response to a question about whether there would be a report on targeting waste, fraud, and abuse in federal spending.
And while there has been no discussion of threats to reduce Social Security payments or the COLA, service to Social Security recipients has already been affected.
Because of one of the changes now in effect, seniors will no longer be able to call the
Social Security Administration to file for benefits or update their banking information. Instead, they’ll have to do so on the agency’s website or—if they can’t verify their identity online—visit an SSA office in person. These new requirements could pose a particular hardship for older beneficiaries residing in rural areas.
The change is expected to add stress to the agency’s already thinning workforce, which is being significantly downsized as part of the Trump administration's effort to reduce the size of the federal workforce. At the same time, the change would also make things more difficult for older and disabled beneficiaries who might have trouble getting into an office or struggle with online services.
For seniors who now have to visit a Social Security office in person, the average wait time on the phone to schedule an in-person appointment has exceeded two hours, and the wait to make an in-person appointment has been over a month. It is expected that these delays will only worsen as the Social Security Administration cuts thousands of staff and millions more people need to make appointments.
The agency has announced plans to reduce its workforce by up to 12 percent, a move that comes at a time when staffing levels are at a 50-year low. It has also offered early retirement and other incentives to the entire staff and will close six of its 10 regional offices, which coordinate and provide support to employees. Of its 1,200 field offices that directly serve the public, more than forty are believed to be on the list of closures.
According to one report, the Social Security Administration's website crashed four times in 10 days in March due to server overload, blocking millions of retirees and people with disabilities from accessing their online accounts. Amid all this, the agency no longer has a system to monitor customer experience because that office was eliminated as part of the cost-cutting efforts led by Elon Musk.
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The Trump Administration and Medicare
When the COVID-19 pandemic struck the country, the use of telehealth became increasingly popular as a means of staying in contact with healthcare providers without needing to visit an office. Although the use of telehealth has declined since the end of the pandemic, it remains more frequently used than before the COVID-19 outbreak.
Medicare telehealth coverage was due to expire on December 31, 2024, but then was extended for three months by the American Relief Act. As of March 15, all Medicare users can continue to access most telehealth services until September 30 of this year, thanks to a law passed by Congress.
Medicare patients in both urban and rural areas can use telehealth services at any location in the United States, including their homes, until September 30. Beginning October 1, you must be in an office or medical facility located in a rural area of the United States for most telehealth services. However, if you aren't in a rural healthcare setting, there are a limited number of telehealth services you will remain eligible to get on or after October 1.
Medicare Part B (medical insurance) covers certain telehealth services, and you'll pay the same amount that you would if you received the services in person. You're responsible for paying 20% of the Medicare-approved amount for your doctor or other health care provider/practitioner’s services, and the Part B deductible applies. For most of these services, you’ll pay the same amount for telehealth services as you do for in-person visits.
With telehealth, you can't receive care that includes procedures requiring a physical examination, taking blood or urine samples, performing X-rays, or administering injections.
Medicare currently offers coverage for preventive health screenings, office visits, and psychotherapy. The menu of covered services was expanded in 2020 to include physical and occupational therapy, emergency department visits, and nursing facility care.
Another issue regarding Medicare appears to be potential policy changes aimed at increasing the use of Medicare Advantage (MA) programs.
Under current regulations, all new Medicare beneficiaries who do not elect a Medicare Advantage (MA) plan are automatically enrolled in the standard Medicare program. Several recent policy proposals, including Project 2025, have suggested promoting MA by making it the default enrollment option for new Medicare beneficiaries.
The Trump Administration could be positioned to adopt such a policy without Congressional action, at least in part. The MA statutes have a “seamless continuation of coverage” clause. This clause, currently not in use, permits the Centers for Medicare and Medicaid Services (CMS) to auto-assign new Medicare beneficiaries to a Medicare Advantage (MA) plan by default when the beneficiary has other coverage, such as an employer plan or individual coverage, through the same organization. Under this authority, CMS could assign all newly eligible (and insured) Medicare beneficiaries to MA plans offered by their current insurer while offering them the opportunity to elect a different plan or switch to the standard program.
Critics of the program, which essentially privatizes Medicare, point to insurance companies cherry-picking enrollees who are younger and healthier and overcharging the program for treatment.
During the hearing earlier this month, the new head of CMS, Dr. Mehmet Oz acknowledged some of these criticisms.
"We're actually apparently paying more for Medicare Advantage than we're paying for regular Medicare — so it's upside down," Oz said. He cited a report from the nonpartisan Medicare Payment Advisory Commission, which found that the federal government "will pay $83 billion more for [Medicare Advantage] enrollees in 2024 than if those beneficiaries had instead been in [traditional Medicare]."
At this point, CMS is poised to make several changes to the MA program under the new Administration; however, whether these changes constitute deregulatory actions, an increase in enrollment, changes to financing, or a combination of all the above remains to be seen.
TSCL opposes privatizing Medicare, and we will be closely monitoring the actions of the Trump Administration in the coming months.
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The Trump Administration and Medicaid
On his first day in office, President Trump revoked an executive order from the Biden era aimed at “protecting and strengthening” the Medicaid program. Since then, executive branch agencies have moved to implement this policy change and initiate a federal funding freeze among the many health policy initiatives being targeted.
However, in a February interview with Fox News, Trump stated he would not cut Medicaid. Nonetheless, Congressional Republicans are pushing for significant Medicaid cuts as part of their plan to extend tax reductions.
As the federal government's funding deadline approaches, Republican lawmakers and the President have outlined ambitious reconciliation plans that require significant cost savings targets to be achieved.
Specifically, the House Energy and Commerce Committee, which has jurisdiction over the Medicaid program, has been tasked with identifying $880 billion in savings.
Since President Trump has been clear that cuts to Medicare and Social Security are off the table, Medicaid remains the primary source for achieving the cost savings necessary to address the enormous funding gap, despite his occasional statements that he won’t cut Medicaid.
That’s why congressional Republicans are revisiting various policies and proposals from the first Trump administration aimed at reducing federal Medicaid spending.
Although these issues are not new, the potential for severe reductions in how states currently secure additional federal funding is now under intense scrutiny.
Such reductions in Medicaid funding would impact all states and could significantly harm hospitals and physicians who provide care to Medicaid populations, as well as the beneficiaries who rely on these services.
While many of the early executive actions affecting healthcare are being examined by the courts, the question is not whether the administration and the 119th Congress will reform Medicaid, but rather how they will reform it.
