Medicare premiums rose during the Trump administration, not fell
Medicare Part B premiums — the monthly charge 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 increases were not unusual. Medicare premiums have risen most years for decades, driven by healthcare costs, inflation, and the cost of new treatments. The Trump administration did not reverse this trend, though some policies affected how much people paid out of pocket in other ways.
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, varying by plan and region.
- The Trump administration did implement some policies that affected Medicare costs, including changes to drug pricing rules and copayment structures.
- Premium increases are driven by healthcare costs and inflation, not by which administration is in office.
- Your actual out-of-pocket costs depend on your specific plan, income level, and which drugs or services you use.
What policies did the Trump administration change
The Trump administration made several changes to Medicare rules, though none lowered the standard Part B premium. In 2020, the administration issued an executive order on drug pricing that aimed to tie Medicare drug prices to international reference prices. The order was not fully implemented before the administration left office, but it signaled a direction toward lower drug costs.
The administration also expanded the use of copayments instead of coinsurance for some beneficiaries, which changed how much people paid at the pharmacy or doctor's office. These changes affected individual out-of-pocket costs differently depending on the plan and the person's income level.
Why do Medicare premiums increase year to year
Medicare premiums rise because the program's costs rise. When more people turn 65 and join Medicare, when healthcare services cost more, and when new drugs and treatments become available, the program spends more money. The Centers for Medicare and Medicaid Services (CMS) calculates premiums based on expected program spending for the coming year.
Inflation also plays a role. If a doctor visit costs more in 2020 than it did in 2019, Medicare's costs go up, and premiums follow. This happens regardless of which party controls Congress or the White House.
How your actual costs differ from the standard premium
The standard Part B premium is what most people pay, but your actual premium may be higher or lower depending on your income. If you earn above a certain threshold, you pay an Income-Related Monthly Adjustment Amount (IRMAA) on top of the standard premium. These thresholds and surcharges change each year.
Your Part D costs also vary widely. The premium you pay depends on which plan you choose, which drugs you take, and whether you may have access to for the Low-Income Subsidy program. Two people on the same plan can pay very different amounts depending on their prescriptions and income.
What changed for out-of-pocket costs under Trump policies
One significant change was the expansion of copayment structures in some Medicare Advantage plans. Traditionally, Medicare beneficiaries paid coinsurance — a percentage of the cost — for most services. Under Trump-era policies, some plans shifted toward fixed copayments, which can be easier to predict but may cost more or less depending on the service.
The administration also worked on reducing surprise medical bills, which occur when you receive care from an out-of-network provider without knowing it. Rules issued during this time required hospitals and insurers to disclose costs upfront in some situations, though full implementation took time.
How to find your actual Medicare costs for this year
Your Medicare.gov account shows your current premium, deductible, and copayment amounts for your specific plan. Log in at Medicare.gov, click "My Medicare," and select "Billing and Payments" to see what you actually owe. This is more accurate than looking at national averages, because your costs depend on your plan choice and income.
If you are comparing plans during Open Enrollment (October 15 to December 7 each year), the Medicare Plan Finder tool lets you enter your prescriptions and see the total estimated cost for each plan option. This shows you premiums plus expected out-of-pocket costs for drugs and services you actually use.
Frequently Asked Questions
Did Trump lower Medicare premiums at any point?
No. Medicare Part B premiums increased every year from 2017 through 2020. Part D premiums also rose during this period. Some policies changed how people paid out of pocket for specific services, but the standard monthly premium did not decrease.
Why did my Medicare premium go up in 2020?
Medicare premiums rise when the program's costs rise. In 2020, the Part B premium increased to $148.50 from $144.60 the previous year. The increase reflected higher healthcare costs and inflation, not a specific policy decision by the Trump administration.
Can I pay a lower Medicare premium if I have a low income?
Yes. If your income is below certain thresholds, you may may have access to for the Low-Income Subsidy program, which reduces your Part D premiums and out-of-pocket costs. You can check your income level and explore through your state Medicaid office or at Medicare.gov.
What is IRMAA and did it change under Trump?
IRMAA is an extra charge added to your Part B and Part D premiums if your income exceeds a threshold. The income thresholds and surcharge amounts are adjusted each year for inflation. IRMAA existed before the Trump administration and continues under current policy.
How do I know if a new administration's policies will lower my Medicare costs?
Changes to Medicare rules take time to implement and affect different people differently. The best way to track your own costs is to review your Medicare.gov account each year during Open Enrollment and compare your current plan to other options available to you.