Medicare premiums rose during the Trump presidency, not fell

Medicare Part B premiums — the monthly cost for doctor visits and outpatient care — increased every year from 2017 through 2020. The premium went from $134 per month in 2017 to $148.50 in 2020. Part D premiums, which cover prescription drugs, also rose during this period, though the amount varied by plan and region.

The Trump administration did not lower Medicare premiums. However, some beneficiaries saw their out-of-pocket costs change due to other policy shifts, including changes to how drug prices were negotiated and how certain medications were covered. Understanding what actually changed — and what stayed the same — helps you track your own costs year to year.

Key Takeaways

  • Medicare Part B premiums increased from $134 monthly in 2017 to $148.50 in 2020 under the Trump administration.
  • Part D prescription drug premiums also rose during this period, though the exact amount depended on your specific plan and location.
  • The Trump administration did make changes to drug pricing policy, but these did not result in lower premiums for most beneficiaries.
  • Medicare premiums are set by Congress and the Centers for Medicare & Medicaid Services based on program costs, not by the sitting president alone.

How Medicare premiums are actually set

Medicare premiums are not set by the president. Instead, the Centers for Medicare & Medicaid Services (CMS) calculates them each year based on the expected costs of the program. Congress can pass laws that change how premiums work, but the year-to-year dollar amounts follow a formula tied to medical inflation and program spending.

Part B premiums are adjusted annually to cover about 25 percent of the program's costs; beneficiaries pay the other 75 percent through general tax revenue. If medical costs rise — because hospitals charge more, doctors order more tests, or drug prices increase — the premium rises too. This happened consistently from 2017 to 2020.

A president can influence premiums indirectly through legislation or executive orders that change how Medicare pays providers or negotiates drug prices. The Trump administration did pursue some of these policies, but the effect on premiums was limited and did not reverse the overall upward trend.

What the Trump administration actually changed about drug costs

The Trump administration issued several executive orders aimed at lowering drug prices, including one that tied Medicare drug prices to international reference prices and another that required rebates to be passed directly to beneficiaries at the pharmacy counter rather than to insurance companies.

These policies were designed to reduce what beneficiaries paid for individual prescriptions, not necessarily to lower the monthly premium itself. Some people with high drug costs may have seen savings on specific medications, but the overall Part D premium continued to rise because the program's total costs did not fall enough to offset the increases.

Many of these executive orders faced legal challenges and were not fully implemented before the administration ended. Some were reversed or modified by the Biden administration, so their long-term impact on Medicare costs remains unclear.

Why Medicare premiums keep rising regardless of who is president

Medicare premiums have risen almost every year since the program began in 1965, regardless of which party controlled the White House. The main drivers are the same across administrations: an aging population, more people using the program, new and expensive treatments, and general healthcare inflation.

When more beneficiaries join Medicare each year and they use more services, the program's costs go up. Even if a president or Congress passes laws to slow the rate of increase, premiums rarely fall. The Trump administration's policies were aimed at slowing the growth rate, not reversing it.

How to track your own Medicare costs year to year

Your actual out-of-pocket costs depend on which plan you chose, not just on the national premium. If you are in Original Medicare (Part A and B), you pay the standard premium set by CMS. If you are in a Medicare Advantage plan or have a Medigap policy, your costs vary by insurer and plan.

Every October, during Open Enrollment, you receive a notice showing your plan's costs for the coming year. Compare your current plan to other options available in your area — sometimes switching plans can lower your total costs even if the national premium went up. The Medicare Plan Finder tool on Medicare.gov lets you see all plans available to you and their costs side by side.

Keep records of your premiums and out-of-pocket costs from year to year. This helps you spot trends in your own spending and decide whether to switch plans when Open Enrollment arrives each fall.

The difference between premiums and out-of-pocket costs

The monthly premium is only one part of what you pay for Medicare. You also pay deductibles (the amount you must spend before insurance kicks in), copayments (a fixed amount per visit), and coinsurance (a percentage of the cost). Changes to any of these can affect your total spending even if the premium stays the same.

During the Trump administration, while premiums rose, some beneficiaries saw changes to their deductibles or copayments depending on their plan. A plan with a higher premium might have had a lower deductible, or vice versa. The total cost to you depends on how much healthcare you actually use, not just on the premium alone.

Frequently Asked Questions

Did Trump's drug pricing executive orders lower what I pay for prescriptions?

Some beneficiaries saw savings on specific drugs, particularly if they took expensive medications. However, the orders were not fully implemented before the administration ended, and many faced legal challenges. The effect varied widely depending on which drugs you took and which plan you were in.

Why do Medicare premiums go up every year?

Premiums rise when the program's costs rise. This happens because the population ages, more people join Medicare, healthcare providers charge more, and new treatments are expensive. These pressures exist regardless of which president is in office.

Can I switch Medicare plans to lower my costs?

Yes. During Open Enrollment (October 15 to December 7 each year), you can switch to a different Medicare Advantage plan, Medigap policy, or Part D plan. Comparing plans available in your area often reveals options with lower premiums or out-of-pocket costs that match your needs better than your current plan.

Is the Medicare premium the same for everyone?

The standard Part B premium is the same nationwide, but higher-income beneficiaries pay more through Income-Related Monthly Adjustment Amounts (IRMAA). Part D and Medicare Advantage premiums vary by plan and location, so two people in the same town might pay different amounts.

Where can I find the official Medicare premium amounts for each year?

The Centers for Medicare & Medicaid Services publishes annual premium amounts on Medicare.gov. You can also call 1-800-MEDICARE to speak with a representative who can tell you the exact premium for your plan and answer questions about your costs.