What is actually happening to Medicare and Medicaid right now

As of early 2025, no law has eliminated Medicare or Medicaid entirely. Both programs still exist and are still paying for healthcare for millions of seniors, disabled people, and low-income families. However, there are real proposals and changes being discussed or implemented that affect how these programs work, who pays for them, and what they cover.

The confusion comes from news coverage of proposed changes, executive actions, and budget discussions. Some proposals would change may be able to access rules, reduce payments to doctors and hospitals, or shift costs to beneficiaries. Others would change how the programs are structured. None of these are the same as eliminating the programs, but they do matter to people who depend on them.

The best way to stay informed is to watch official sources — the Centers for Medicare & Medicaid Services (CMS) website, your state Medicaid office, and your Medicare plan's communications — rather than relying on headlines alone. Changes to these programs happen slowly and usually come with advance notice to people affected.

Key Takeaways

  • Medicare and Medicaid have not been eliminated; both programs continue to operate and cover healthcare for seniors and low-income beneficiaries.
  • Proposed changes may affect may be able to access, coverage, or how much beneficiaries pay out of pocket, but these are different from ending the programs.
  • Changes to federal programs require Congressional action or state-level decisions, and most come with a transition period before they take effect.
  • The official source for accurate information about your coverage is your Medicare plan, your state Medicaid office, or CMS directly — not news reports.
  • If you receive Medicare or Medicaid, you should review any notices you receive from your plan or state and contact them with questions about your coverage.

Types of changes being discussed or proposed

Proposed changes to Medicare and Medicaid fall into several categories. Some focus on reducing what the federal government spends by lowering payment rates to hospitals and doctors. Others would change who is covered — for example, making Medicaid may be able to access stricter or changing income limits. Still others would shift more costs to beneficiaries through higher premiums, deductibles, or copayments.

Budget proposals may also include changes to how the programs are run. For example, some proposals suggest moving Medicare to a different payment model or giving states more control over Medicaid rules. These are structural changes, not eliminations.

The key distinction is this: a proposal to change how much Medicare pays a hospital is not the same as ending Medicare. A change to Medicaid may be able to access rules is not the same as eliminating Medicaid. Understanding what is actually being proposed — rather than the headline — helps you know what might affect you.

How changes to Medicare and Medicaid actually happen

Medicare is a federal program run by the Centers for Medicare & Medicaid Services. Changes to Medicare coverage, may be able to access, or benefits require an act of Congress. The President can propose changes in a budget, but Congress must vote to pass them into law. This process takes months and involves public comment periods, hearings, and debate.

Medicaid is jointly run by the federal government and each state. States have more flexibility to change their Medicaid programs than they do with Medicare, but major changes still require state legislative action or approval from CMS. Some changes can happen through executive action or regulatory changes, but these are usually narrower in scope.

When changes do happen, they are almost never when ready. There is usually a transition period — sometimes months, sometimes years — before a new rule takes effect. This gives people time to understand what is changing and plan accordingly.

What to watch for if you have Medicare

If you are on Medicare, the best way to stay informed is to read the notices you receive directly from your plan or from Medicare. Every year, Medicare sends an "Important Notice About Your Rights and Protections" and information about changes to your coverage. Your plan also sends annual notices about changes to premiums, deductibles, and covered services.

You can also check the official Medicare website at Medicare.gov, which has a section on "What's New" that lists recent changes and proposed changes. The site also has a phone number — 1-800-MEDICARE — where you can speak to someone about your specific coverage.

If you see a news story about changes to Medicare and you are unsure whether it affects you, contact your plan directly or call Medicare. Do not assume a proposal that has been announced is already in effect. Many proposed changes never become law.

What to watch for if you have Medicaid

Medicaid rules vary by state, so changes in one state may not explore to another. If you receive Medicaid, your state Medicaid office is your primary source of information. Most states have a Medicaid website where you can find information about coverage, may be able to access, and any changes being made.

You should also read any notices you receive from your state Medicaid program or your Medicaid managed care plan. These notices will tell you about changes to your coverage, your costs, or your may be able to access. If you do not understand a notice, call the number on it and ask for clarification.

Some states have made changes to Medicaid may be able to access in recent years — for example, by ending the continuous enrollment that was in place during the pandemic. These changes are real and do affect coverage, but they happen through state action, not through the federal program being eliminated.

How to find out what is actually changing

When you hear news about changes to Medicare or Medicaid, here are the official sources to check:

  • Medicare.gov — The official Medicare website has information about coverage, changes, and how to contact Medicare.
  • Your state Medicaid office — Search "[your state] Medicaid" to find your state's official Medicaid website and contact information.
  • Your plan's website or customer service number — Your Medicare plan or Medicaid managed care plan will notify you directly about changes that affect you.
  • CMS.gov — The Centers for Medicare & Medicaid Services website has information about proposed rules, final rules, and policy changes.
  • Congress.gov — If you want to track proposed legislation about Medicare or Medicaid, you can search for bills on this official site.

These sources will give you accurate, detailed information rather than headlines that may oversimplify what is happening.

Questions to ask your doctor or plan if you are worried about coverage

If you are concerned about changes to your coverage, here are specific questions to ask:

  • "Are there any changes coming to my coverage or my costs in the next year?"
  • "If my coverage changes, what will I need to do to stay covered?"
  • "Where can I find official information about changes to my plan?"
  • "If I disagree with a coverage decision, how do I appeal it?"
  • "What should I do if I receive a notice about changes to my Medicaid or Medicare?"

Your plan's customer service line is required to answer these questions. If you do not get a clear answer, ask to speak to a supervisor or contact your state's insurance commissioner's office.

Frequently Asked Questions

Can the President eliminate Medicare or Medicaid without Congress?

No. Medicare is a federal program created by law, and only Congress can eliminate it or make major changes to it. The President can propose changes in a budget or through executive actions, but these must be approved by Congress to become law. Medicaid is also created by federal law, though states have more flexibility to make changes within their programs.

If I lose Medicaid, what happens to my healthcare?

If your Medicaid coverage ends, you would need to find another way to pay for healthcare. You may be able to purchase a plan through the Affordable Care Act marketplace, explore for Medicare if you are 65 or older or disabled, or find a community health center that offers sliding-scale fees. Contact your state Medicaid office or call 211 to learn what options are available in your area.

How will I know if changes to Medicare or Medicaid affect me?

Your plan or state Medicaid office will send you a notice if changes affect your coverage or costs. You will also receive annual notices about changes coming in the next year. Read these notices carefully and contact your plan if you have questions. Do not wait for a news story to find out about changes — official notices are your most reliable source.

What if I disagree with a change to my coverage?

Both Medicare and Medicaid have appeal processes. If your plan denies coverage for something you think should be covered, you can file an appeal. Your plan is required to tell you how to appeal in any denial letter. You can also contact your state's insurance commissioner's office or, for Medicare, call 1-800-MEDICARE for help with an appeal.

Where can I get help understanding notices from my plan?

Call your plan's customer service number — it is on your insurance card. You can also call 1-800-MEDICARE for Medicare questions or your state Medicaid office for Medicaid questions. Many areas also have patient advocates or community health workers who can help you understand your coverage for free.