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 Part B premium went from $109.80 per month in 2017 to $144.60 per month in 2020. Part D premiums, which cover prescription drugs, also rose during this period, though the amount varied by plan and region.

The increases happened because of how Medicare premiums are set. Part B premiums are tied to the cost of providing care, the number of people enrolled, and the amount of money the program spends. When medical costs go up or enrollment grows, premiums rise to cover those expenses. This happens regardless of which president is in office.

Some people may remember hearing about premium freezes or reductions in specific years. In 2019, some beneficiaries with higher incomes saw their Part B premiums hold steady rather than increase, but most people still paid more than they had the year before. These changes affected only a small portion of Medicare beneficiaries and were driven by how the program calculates costs, not by policy changes.

Key Takeaways

  • Medicare Part B premiums increased every year from 2017 to 2020, rising from $109.80 to $144.60 per month.
  • Medicare premiums are set by a formula based on program costs and enrollment, not by presidential policy decisions.
  • A 2019 premium freeze applied only to beneficiaries with higher incomes and did not affect most Medicare members.
  • Part D prescription drug premiums also rose during this period, though amounts varied by plan and location.

How Medicare premiums are actually set

Medicare Part B premiums are calculated using a formula set by federal law. The Centers for Medicare & Medicaid Services (CMS) estimates the cost of providing Part B services for the coming year, subtracts the money already collected from beneficiaries, and divides the remainder by the number of people enrolled. The result is the premium amount.

This formula has been in place for decades and does not change based on who is president. When medical costs rise — because hospitals charge more, doctors' fees increase, or new treatments become available — premiums rise to match. When enrollment grows, the cost is spread across more people, but if total program spending grows faster than enrollment, premiums still go up.

Part D premiums work differently. Insurance companies that offer Part D plans set their own premiums, subject to CMS review. These premiums depend on the plan's expected drug costs, the insurance company's administrative expenses, and profit margins. Plans compete on price, so premiums vary widely even within the same region.

What changed in 2019 and why people remember it differently

In 2019, the Part B premium did not increase for most beneficiaries — it stayed at $135.50, the same as 2018. However, this was not a freeze for everyone. Beneficiaries with higher incomes (over $85,000 for individuals, $170,000 for couples) paid more because of Income-Related Monthly Adjustment Amounts (IRMAA), a surcharge added to premiums based on tax return information.

The 2019 premium hold happened because Part B spending came in lower than expected in 2018. When the program spends less than projected, the premium can stay flat or even decrease. This is a built-in feature of how the formula works — it is not something an administration creates or controls.

Some news coverage in 2019 attributed the premium freeze to administration policy, which led to confusion. In reality, the freeze was the result of lower-than-expected medical spending that year. The following year, premiums rose again as spending increased.

Part D premiums and drug costs during this period

Part D prescription drug premiums increased during the Trump administration, though the size of the increase varied by plan and region. Some plans saw premiums rise by a few dollars per month, while others increased by $10 or more. The average Part D premium across all plans rose from roughly $32 per month in 2017 to around $40 per month by 2020, though these figures vary depending on the source and the specific plans measured.

Drug costs themselves — what Medicare and beneficiaries pay for medications — also rose during this period. Pharmaceutical companies increased prices on existing drugs, and new specialty drugs for conditions like cancer and biologics for autoimmune diseases entered the market at high prices. These costs flow through to Part D premiums.

The Trump administration did take some actions related to drug pricing, including issuing executive orders aimed at lowering drug costs. However, these policies had limited effect during his term, and drug prices continued to rise overall. The relationship between policy and premium changes is complex and takes time to show up in actual premium amounts.

Comparing premium changes across administrations

Medicare premiums have risen under every administration since the program began in 1965. The rate of increase varies year to year based on medical inflation, enrollment growth, and program spending — not based on which party controls the White House.

From 2009 to 2016 (the Obama administration), Part B premiums rose from $96.40 to $121.80 per month. From 2017 to 2020 (the Trump administration), they rose from $109.80 to $144.60. From 2021 onward (the Biden administration), they continued to rise, reaching $164.90 by 2022. These increases reflect the underlying cost of medical care, not political choices.

It is common for people to remember premium changes from a particular year and attribute them to the president in office at that time. In reality, premiums are set by formulas that respond to program costs, and those costs are driven by factors like inflation, new medical technology, and population health — not by executive decisions.

What you can do about rising premiums

If your Medicare premiums have increased, you have several options. You can review your Part D plan every year during the annual enrollment period (October 15 to December 7) and switch to a plan with a lower premium if one is available in your area. You can also check whether you may have access to for Extra Help, a program that covers Part D premiums and cost-sharing for people with limited income and resources.

For Part B premiums, you cannot choose a different plan — the premium is the same for everyone in your area. However, if your income has decreased, you may be able to request a reduction in your IRMAA surcharge by contacting Social Security and providing documentation of your income change.

Some people may have access to for Medicaid or Medicare Savings Programs, which can help pay Part B premiums and other out-of-pocket costs. Your state Medicaid office or local Area Agency on Aging can tell you whether you meet the income and resource limits for these programs.

Frequently Asked Questions

Did any Medicare premiums go down during the Trump administration?

Part B premiums did not decrease during the Trump administration. They increased every year from 2017 to 2020. In 2019, the premium held steady at $135.50 for most beneficiaries, but this was not a decrease — it was a freeze compared to the previous year. For beneficiaries with higher incomes, premiums actually increased in 2019 due to IRMAA adjustments.

Can a president control Medicare premiums?

No. Medicare premiums are set by formulas written into federal law. A president can propose changes to those formulas through Congress, but cannot unilaterally lower premiums. The formulas respond to program costs, enrollment, and spending — factors that are largely outside any single administration's control.

Why do Medicare premiums keep going up?

Medicare premiums rise because the cost of medical care rises. Hospitals and doctors increase their fees, new medications and treatments are expensive, and the population using Medicare is growing. These costs are spread across all beneficiaries through premiums. Medical inflation typically outpaces general inflation, so Medicare premiums often increase faster than Social Security benefits or other income sources.

Is there a way to lower my Medicare costs without changing plans?

You can reduce your out-of-pocket costs by using preventive services, which Medicare covers at no cost. You can also ask your doctor about generic medications instead of brand-name drugs, which can lower your Part D costs. If your income has decreased, contact Social Security to request an IRMAA reduction, which can lower your Part B premium.

When can I change my Medicare plan to find a lower premium?

You can change your Part D plan during the annual enrollment period from October 15 to December 7 each year. Changes take effect January 1. You can also switch plans if you have a may have access to life event, such as moving to a new state, losing employer coverage, or a significant change in income.